title: Prognostic value of T-cell receptor gamma rearrangement in peripheral blood or bone marrow of patients with peripheral T-cell lymphomas.
abstract: Peripheral T-cell lymphomas (PTCL) have a variable outcome. We have investigated the prognostic value of molecular staging in non-anaplastic PTCL. T-cell receptor gamma rearrangements were routinely determined in peripheral blood (n = 40) and bone marrow (n = 38) of patients with PTCL (75% unspecified) by conventional PCR at diagnosis. Tissue controls for PCR included 24 tumour biopsies. Twenty-four patients (60%) had a PCR-detectable clonal TCR gamma rearrangement in PB or BM. These TCR gamma PCR positive patients had significantly more stage IV disease (14 patients of 15 patients; P = 0.001), elevated LDH (14 of 18 patients; P = 0.04), higher IPI (16 of 21 patients; P = 0.03), more anemia (15 of 19 patients; P = 0.02) and lower platelet counts (seven of seven patients; P = 0.02). Clinical outcome of this clonal group was characterised by lower complete remission rates (37.5% vs. 62.5%), and overall response rates (58.3% vs. 87.5%; P < 0.05) as well as a significantly shorter median overall survival (12.8 vs. 30.0 months; P = 0.006). Patients with clinical stages I - III but molecular stage IV had an equally poor overall survival when compared with patients with clinical stage IV (15.8 vs. 13.9 months). In contrast, patients with CS I - III in the absence of a TCR gamma rearrangement in PB or BM had a favourable outcome with an estimated overall survival of 70% at 3 and 5 years. Molecular staging in PB and BM by TCR gamma PCR at diagnosis may serve as a useful prognostic tool in PTCL.
authors.affiliation: Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, A-1090 Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Schützinger
authors.forename: Harald
authors.initials: H
authors.lastname: Esterbauer
authors.forename: Gregor
authors.initials: G
authors.lastname: Hron
authors.forename: Cathrin
authors.initials: C
authors.lastname: Skrabs
authors.forename: Martin
authors.initials: M
authors.lastname: Uffmann
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
authors.forename: Alexander
authors.initials: A
authors.lastname: Hauswirth
authors.forename: Christine
authors.initials: C
authors.lastname: Mannhalter
authors.forename: Karin
authors.initials: K
authors.lastname: Dieckmann
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
authors.forename: Michael
authors.initials: M
authors.lastname: Formanek
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
authors.forename: Josef
authors.initials: J
authors.lastname: Friedl
authors.forename: Alexander
authors.initials: A
authors.lastname: Gaiger
authors.forename: Andreas
authors.initials: A
authors.lastname: Chott
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jäger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001773:Blood Cells; D001853:Bone Marrow; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011379:Prognosis; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics*; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D016692:Receptors, Antigen, T-Cell, gamma-delta