Angioimmunoblastic T-cell lymphoma: the effect of initial treatment and microvascular density in 31 patients

Abstract

The objectives of this study are to explore the clinical features and treatment outcomes and to investigate the correlation between microvessel density (MVD) and survival in patients with angioimmunoblastic T-cell lymphoma (AITL). We retrospectively analyzed clinical and follow-up data of 31 patients treated in two hospitals during 1995-2009 histologically proven AITL. We also assessed MVD in the lump of 31 previously untreated patients using α-CD34 immunohistochemical staining. The median age of the 31 patients was 48 years, eighty percent of the patients were in an advanced stage. 67.7% of them had B symptoms, with the follow-up of 2-13 years, the 5-year overall survival rate was 25.8%. The response rates (RR) of CHOP group and COP (cyclophosphamide, vincristine and prednisolone) group are 76.5 and 75%, respectively, which is no significant difference (P=0.894). RR did not differ whether chemotherapy regimens contained anthracycline or not. The 3-year PFS rate for patients who received COP and CHOP regimen was 25.4 and 35.3% (P=0.562), while 5-year OS rates were 25.0 and 29.4%, respectively (P=0.667). The median PFS for patients with high MVD and low MVD were 15.1 and 30.0 months (P=0.048), while the median OS were 20 and 45 months, respectively (P=0.038). Patients who were sensitive to initial chemotherapy COP regimen have the similar therapeutic effect to CHOP regimen. Patients with high MVD measured in the microenvironment had worse PFS and OS than AITL patients with low expression.

Prognostic Value of Microvessel Density in Non-Hodgkin Lymphoma: A Meta-Analysis

“…NHL [11, 23] and B-NHL [12, 24] were both investigated by 2 studies. Mantle cell lymphoma [25], primary pulmonary lymphoma [26], and angioimmunoblastic T-cell lymphoma [27] were investigated by 1 study, respectively. Immunohistochemical staining on tissue section or tissue microarray with antibodies against CD31, CD34, or factor VIII was used to assess MVD.…”

Recombinant human endostatin in combination with CHOP regimen for peripheral T cell lymphoma

“…This high vascularity might attribute to a worse prognosis under anthracycline-based chemotherapy,26,27 the 5-year OS of AITL being only 33%–41% 28–31. Combined anti-angiogenesis drug with conventional chemotherapy may improve the survival of AITL patients.…”

Skin lesions and neutrophilic leukemoid reaction in a patient with angioimmunoblastic T‐cell lymphoma: a case report and review of the literature

“…Skin rashes imply poor prognosis [4,23,24]. Other factors, such as male sex, B symptoms, edema, ascites, mediastinal lymphadenopathy, anemia, thrombocytopenia, lymphocytopenia, elevated white blood cell, decreased hemoglobin, elevated IgA levels, lymph node eosinophilia, the presence of clear and convoluted cells, high microvessel density measured in the microenvironment, higher ratio of M2 macrophages, failure to achieve complete remission, and drug exposure are reported to correlate with poor prognosis [2,3,[23][24][25][26][27][28]. So far, due to limited data available, prognostic factors in AITL sometimes yield controversial results.…”