Contributions
Abstract: PB1786
Type: Publication Only
Background
Peripheral T-cell lymphomas (PTCLs) are a rare heterogeneous group of lymphoid malignancies (5-15% of all non-Hodgkin lymphomas) with aggressive clinical behavior. There are three most common subtypes of PTCLs: Peripheral T-Cell Lymphoma (NOS), ALCL and AICL. Compared to B-cell lymphomas, which incidence remains stable, level of T-cell lymphomas have been rising continuously. Despite worldwide standard of first-line treatment, using anthracycline-based regimens, there is a need for better management of this patients. Unfortunately, due to lack of cases and randomized clinical trials, there are still inconsistency of specific prognostic factors in PTCLs.
Aims
The primary endpoint was event-free survival (EFS) and overall survival (OS), depending on PTCL type. We evaluated the influence on patients outcomes of different prognostic factors, which are included in PTCLs prognostic scores (IPI, IPTCL, PIT, mPIT).
Methods
We analyzed 50 patients (median age: 57, range: 22-80 years; males: 34, females: 16) with PTCLs treated from Sep 2006 to Feb 2018 in NCI (Kiev, Ukraine). Twenty two patients (44%) have PTCL (NOS), ALK –ve were 11 (22%) pts, ALK +ve - 11 (22%) pts and 6 (12%) have unknown ALK status. 82% and 18% pts were younger and older than 65 y.o, respectively. They were assessed with IPI, IPTCLP, PIT and mPIT prognostic scores. Patients received CHOP-like chemotherapy regimens (CHOP, CHOEP, EPOCH).
Results
ORR was observed in 66% cases, progression on therapy had 34% pts. We registered 48% of relapses after the 1-st line therapy during the follow-up period (median – 11 months; range 1–85 months).
EFS was associated with LDH level (>620 U/l) and stage (III-IV) by ROC analysis [Sp=64.71%, Se=82.35%, AUC= 0.74, p=0,0011] and [Sp=66.67%, Se=65.38%, AUC= 0.66, p=0,03], respectively. 3-year EFS showed worse outcomes in pts with high LDH level 25% vs 75% in pts with normal LDH (p<0.05). Patients with stage I-II had better 3-years EFS compared to stage III-IV, 62% vs 15%, respectively (p<0.05).
Also, multivariate analysis revealed that ECOG influence on EFS with HRs of 3.3 [95% CI 1.16–9.5, p = 0.001]. The 3-year EFS in patients with ECOG <1 was 50% vs 15% with ECOG >1.
Any significant difference was found between bone marrow involvement, age, gender, B-symptoms, Ki-67, albumin, ANC, platelets level and EFS rate. Also, there was no superiority between conventional CHOP vs more intensive CHOEP ana EPOCH ( p=0.16).
5-year OS was 33%, 45% and 90% in PTCL (NOS), ALK –ve and ALK +ve, respectively (p<0.05).
Conclusion
PTCLs are still remaining a rare group of lymphoid malignancies, which are difficult to cure. Over the last decades, several studies showed prognostic evaluation in clinical and pathologic features of PTCLs. In our retrospective analyses we identified LDH level (>620 U/l), stage (III-IV) and
ECOG >1, as the most valuable factors that predict a lower level of EFS in patients with PTCL (NOS), ALK –ve, ALK +ve lymphomas.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): ALCL, Peripheral T-cell lymphoma, Prognostic factor, t cell lymphoma
Abstract: PB1786
Type: Publication Only
Background
Peripheral T-cell lymphomas (PTCLs) are a rare heterogeneous group of lymphoid malignancies (5-15% of all non-Hodgkin lymphomas) with aggressive clinical behavior. There are three most common subtypes of PTCLs: Peripheral T-Cell Lymphoma (NOS), ALCL and AICL. Compared to B-cell lymphomas, which incidence remains stable, level of T-cell lymphomas have been rising continuously. Despite worldwide standard of first-line treatment, using anthracycline-based regimens, there is a need for better management of this patients. Unfortunately, due to lack of cases and randomized clinical trials, there are still inconsistency of specific prognostic factors in PTCLs.
Aims
The primary endpoint was event-free survival (EFS) and overall survival (OS), depending on PTCL type. We evaluated the influence on patients outcomes of different prognostic factors, which are included in PTCLs prognostic scores (IPI, IPTCL, PIT, mPIT).
Methods
We analyzed 50 patients (median age: 57, range: 22-80 years; males: 34, females: 16) with PTCLs treated from Sep 2006 to Feb 2018 in NCI (Kiev, Ukraine). Twenty two patients (44%) have PTCL (NOS), ALK –ve were 11 (22%) pts, ALK +ve - 11 (22%) pts and 6 (12%) have unknown ALK status. 82% and 18% pts were younger and older than 65 y.o, respectively. They were assessed with IPI, IPTCLP, PIT and mPIT prognostic scores. Patients received CHOP-like chemotherapy regimens (CHOP, CHOEP, EPOCH).
Results
ORR was observed in 66% cases, progression on therapy had 34% pts. We registered 48% of relapses after the 1-st line therapy during the follow-up period (median – 11 months; range 1–85 months).
EFS was associated with LDH level (>620 U/l) and stage (III-IV) by ROC analysis [Sp=64.71%, Se=82.35%, AUC= 0.74, p=0,0011] and [Sp=66.67%, Se=65.38%, AUC= 0.66, p=0,03], respectively. 3-year EFS showed worse outcomes in pts with high LDH level 25% vs 75% in pts with normal LDH (p<0.05). Patients with stage I-II had better 3-years EFS compared to stage III-IV, 62% vs 15%, respectively (p<0.05).
Also, multivariate analysis revealed that ECOG influence on EFS with HRs of 3.3 [95% CI 1.16–9.5, p = 0.001]. The 3-year EFS in patients with ECOG <1 was 50% vs 15% with ECOG >1.
Any significant difference was found between bone marrow involvement, age, gender, B-symptoms, Ki-67, albumin, ANC, platelets level and EFS rate. Also, there was no superiority between conventional CHOP vs more intensive CHOEP ana EPOCH ( p=0.16).
5-year OS was 33%, 45% and 90% in PTCL (NOS), ALK –ve and ALK +ve, respectively (p<0.05).
Conclusion
PTCLs are still remaining a rare group of lymphoid malignancies, which are difficult to cure. Over the last decades, several studies showed prognostic evaluation in clinical and pathologic features of PTCLs. In our retrospective analyses we identified LDH level (>620 U/l), stage (III-IV) and
ECOG >1, as the most valuable factors that predict a lower level of EFS in patients with PTCL (NOS), ALK –ve, ALK +ve lymphomas.
Session topic: 21. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): ALCL, Peripheral T-cell lymphoma, Prognostic factor, t cell lymphoma