title: Clinical relevance of immunophenotype in a retrospective comparative study of 297 peripheral T-cell lymphomas, unspecified, and 496 diffuse large B-cell lymphomas: experience of the Intergruppo Italiano Linformi.
abstract: BACKGROUND
  To assess the impact of T-cell/B-cell phenotype on clinical outcome, the authors retrospectively compared patients who had peripheral T-cell lymphoma, unspecified (PTCL-U), with patients who had diffuse large B-cell lymphoma (DLBCL).
  
  
  METHODS
  Two hundred ninety-seven cases of PTCL-U and 496 cases of DLBCL that had been transferred from the files of the Intergruppo Italiano Linfomi or the Gruppo Italiano Linfomi were integrated into a unique working file and reviewed by the authors.
  
  
  RESULTS
  The PTCL-U group and the DLBCL group had significantly different distribution patterns with respect to patient age, gender, disease stage, performance status (PS), the presence or absence of systemic "B" symptoms, the presence or absence of bulky disease, lactic acid dehydrogenase (LDH) levels, and number of extranodal sites (ENS). A significantly greater number of patients in the DLBCL group experienced complete remission (P < 0.0001). Multinomial logistic regression analysis confirmed that immunophenotype, PS, LDH concentration, and number of ENS were independent predictors of response. At a median follow-up duration of 43 months, there was no observable difference in disease-free survival (DFS) between patients with DLBCL and patients with PTCL-U; however, multivariate analysis did reveal that poorer PS and bone marrow involvement were significantly associated with shorter DFS. Furthermore, although the overall survival (OS) curves associated with the T-cell and B-cell immunophenotypes were significantly different from each other at a median follow-up duration of 37 months (P = 0.0012), Cox multivariate analysis excluded immunophenotype from the final OS model.
  
  
  CONCLUSIONS
  The findings made in the current study indicate that the natural history of PTCL-U may differ from that of DLBCL. Patients with PTCL-U tended to have less favorable clinical outcomes, although the observed difference in outcome was only partially attributable to immunophenotype, which was independently associated with response, but not with survival. Differences in prognostic factor distributions between patients with PTCL-U and patients with DLBCL may account for some portion of the expected phenotype-associated risk.
authors.affiliation: Centro Trapianti Midollo Osseo, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. fortunato_morabito@tin.it
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallamini
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Callea
authors.forename: Cesare
authors.initials: C
authors.lastname: Guglielmi
authors.forename: Santo
authors.initials: S
authors.lastname: Neri
authors.forename: Antonio
authors.initials: A
authors.lastname: Lazzaro
authors.forename: Lorella
authors.initials: L
authors.lastname: Orsucci
authors.forename: Fiorella
authors.initials: F
authors.lastname: Ilariucci
authors.forename: Stefano
authors.initials: S
authors.lastname: Sacchi
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D016393:Lymphoma, B-Cell / Q000276:immunology* / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000276:immunology* / Q000401:mortality; D016411:Lymphoma, T-Cell, Peripheral / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies