Ukrainian data on prognostic factors and treatment outcomes in patients with peripheral T-cell lymphomas.

Tetiana Skrypets, Olga Novosad, Yan Pastushenko, Oleksandr Gorbach, Iryna Kriachok

Abstrakt


Background: PTCLs is a diverse group of lymphomas (10-15% of all NHLs) with aggressive behavior. Despite the standard of first-line anthracycline-containing regimens, clinical outcomes are poor compared to B-cell lymphomas.Also, there are still debates about specific prognostic factors in PTCLs. 

 

Aims.Primary endpoints - EFS and OS. To evaluate the prognostic significance of 5 PTCLs scores (IPI, IPTCL, PIT, mPIT and T-cell score). 

 

Patients and methods. From 67 registered patients only 50 were included: PTCL-NOS (22, 44%), ALCL ALK+ (10, 20%) and ALK - (18, 36%). Patients received CHOP-like regimens (CHOP, CHOEP, EPOCH). 

 

Results. ORR was observed in 66% cases (CR-78%).There were48% of relapses after the 1-st line therapy during follow-up (median – 11 months; range 1–85 months). Median age 57 (range 22-80) with male predominance - 62%. 40% ofpts were > 60 years old, 48% had stage III-IV.Majority of patients were assessed by 5 prognostic scores. 

IPI (45 pts)

The 3-year EFS and OS were higher with IPI ≤1 vs IPI >2 (80% vs 18% and 87% vs 27%, respectively, p=0.0002). ROC analysis confirmed poor clinical outcome to patients with >1 PF (Se=88 %; Sp=68 %; AUC=0.7, p=0.0081).

IPTCLP (41 pts) 

The presence of PF=1-2 showed EFS and OS reduction. A 3-year EFS rate for 1-2 PF was 25% vs 70% for PF=0 (p=0.003). Thus, 3-year OS in patients with PF=0 vs PF=1-2 was 100% vs 20% (p=0.0001).

PIT (42 pts) 

Better 3-year EFS and OS in patients with PF=0 vs PF=1-3 (88% vs 28% and 100% vs 34%, respectively, p=0.001). Patients with PF=1-3 have a higher rate of relapses vs PF=0, (p=0.0005 by Cox-test).

mPIT (21 pts): 

Any significant difference between PF and clinical outcomes.

T-cell score (18 pts) 

Higher survivalrates with PF≤2. More than 2 PF have an impact on EFS(p=0.005). The 3-years OS in patients with PF≤2 was 77% vs 25% in cases with PF ≥3 (p=0.001). 

 

Conclusions.IPI, PIT, IPTCLP are still very useful in defining risk stratification. As to mPIT and T-cell score, it could be suggested, that we need more patients to evaluate their prognostication possibility.


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