title: Lymphopenia is an important prognostic factor in peripheral T-cell lymphoma (NOS) treated with anthracycline-containing chemotherapy.
abstract: BACKGROUND
  Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) is a heterogeneous group of aggressive T-cell lymphomas with poor treatment outcomes. The aim of this study was to evaluate whether lymphopenia at diagnosis would have an adverse effect on survival in patients with PTCL-NOS treated with anthracycline-containing chemotherapy.
  
  
  METHODS
  A total of 118 patients with PTCL-NOS treated with anthracycline-containing chemotherapy from 4 Korean institutions were included.
  
  
  RESULTS
  Thirty-six patients (30.5%) had a low absolute lymphocyte count (ALC, < 1.0 × 109/L) at diagnosis. Patients with lymphopenia had shorter overall survival (OS) and progression-free survival (PFS) rates compared with patients with high ALCs (P = 0.003, P = 0.012, respectively). In multivariate analysis, high-intermediate/high-risk International Prognostic Index (IPI) scores and lymphopenia were both associated with shorter OS and PFS. Treatment-related mortality was 25.0% in the low ALC group and 4.8% in the high ALC group (P = 0.003). In patients considered high-intermediate/high-risk based on IPI scores, lymphopenia was also associated with shorter OS and PFS (P = 0.002, P = 0.001, respectively).
  
  
  CONCLUSIONS
  This study suggests that lymphopenia could be an independent prognostic marker to predict unfavorable OS and PFS in patients with PTCL-NOS treated with anthracycline-containing chemotherapy and can be used to further stratify high-risk patients using IPI scores.
authors.affiliation: Division of Hematology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Yu Ri
authors.initials: YR
authors.lastname: Kim
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyun Ae
authors.initials: HA
authors.lastname: Jung
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Lee
authors.forename: Hyeon Seok
authors.initials: HS
authors.lastname: Eom
authors.forename: Seong Hyun
authors.initials: SH
authors.lastname: Jeong
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: June-Won
authors.initials: JW
authors.lastname: Cheong
authors.forename: Yoo Hong
authors.initials: YH
authors.lastname: Min
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D016411:Lymphoma, T-Cell, Peripheral / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008231:Lymphopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents