title: Peripheral T-cell lymphomas: analysis of histology, staging and response to treatment of 208 cases at a single institution.
abstract: Peripheral T-cell lymphomas are characterized by a poor clinical outcome. We retrospectively analyzed 208 adults treated in our institution between 2000 and 2011. Median age at diagnosis was 55 years. Fifty-one percent had B symptoms and 51% serum elevated lactate dehydrogenase (LDH) levels. Eastern Cooperative Oncology Group (ECOG) performance status (PS) was 0-1 in 63% and 2-4 in 37%. According to Ann Arbor classification, 16% were at stage I-II and 84% at stage III-IV. Histological subtypes were: 39% peripheral T-cell non-Hodgkin lymphoma (NHL) unspecified (PTCL-U), 19.5% anaplastic large cell lymphoma (ALCL), with 9.5% ALK+ and 10% ALK-, and 25% angioimmunoblastic lymphoma (AILT). Primary extranodal lymphoma represented 17%, and 8% were diagnosed with hemophagocytosis. Induction chemotherapy was CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) in 87% of patients. The median number of chemotherapy cycles was 2 (1-7). A complete response was obtained in 57% of the patients. Among them, 32% had an autologous stem cell transplant (ASCT) and 10% allogeneic SCT, while 38% were primary refractory. Five-year overall survival (OS) was 28.5% (22.3-36.3), and 5-year event-free survival (EFS) was 18.4% (13.4-25.3). A multivariate analysis showed that ALCL-ALK+ (p = 0.004), AILT (p < 0.01), extranodal involvement (p = 0.001), PS > 1 (p = 0.04), LDH < normal (p = 0.003) and hemophagocytosis (p = 0.001) were independent adverse factors for OS. We conclude that conventional chemotherapy with intensive treatment is not sufficient to improve the response rate. Optimal management is required.
authors: Centre de lutte contre le cancer Institut Paoli Calmettes , Marseille , France.
authors: Florence
authors: F
authors: Broussais-Guillaumot
authors: Diane
authors: D
authors: Coso
authors: Nawel
authors: N
authors: Belmecheri
authors: Vadim
authors: V
authors: Ivanov
authors: Jean-Marc
authors: JM
authors: Schiano de Collela
authors: Thérèse
authors: T
authors: Aurran-Schleinitz
authors: Anne-Marie
authors: AM
authors: Stoppa
authors: Bruno
authors: B
authors: Chetaille
authors: Luc
authors: L
authors: Xerri
authors: Benjamin
authors: B
authors: Esterni
authors: Didier
authors: D
authors: Blaise
authors: Reda
authors: R
authors: Bouabdallah
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult