Clinical relevance of immunophenotype in a retrospective comparative study of 297 peripheral T‐cell lymphomas, unspecified, and 496 diffuse large B‐cell lymphomas

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. Cancer 2004. © 2004 American Cancer Society

Pharmacodynamic and pharmacokinetic study of pegylated liposomal doxorubicin combination (CCOP) chemotherapy in patients with peripheral T-cell lymphomas

“…The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) remains the most commonly used chemotherapeutic treatment for PTCL. However, CHOP has poor efficacy, a low CR rate (10%-60%) and a median overall survival (OS) of <3 years [5][6][7] . Moreover, doxorubicin has a low therapeutic index and significant treatment-related toxicities, whereas pegylated liposomal doxorubicin (PLD) has a stable spatial structure and demonstrates reduced binding to plasma proteins.…”

Peripheral T-cell lymphoma unspecified type presenting with a pneumothorax as the initial manifestation: A case report and literature review

“…The disease-free and overall survival times of patients with PTCL-u following conventional CHOP treatment are markedly lower than those of patients with B-cell lymphoma (30,31). Novel therapeutic approaches aiming to improve upon the short-term and long-term efficacy of the currently available PTCL-u treatments are being investigated at present.…”

Comparison of Long-Term Clinical Outcomes of CHOP Chemotherapy between Japanese Patients with Nodal Peripheral T-Cell Lymphomas and Those with Diffuse Large B-Cell Lymphoma in the Study Group of the Tohoku Hematology Forum

“…15,16 In Western countries, by contrast, high-risk groups account for only 42-46% of patients with PTCL. 2,9,17 Although the IPI for PTCLs appears to be higher in Japan than in Western countries, international studies with large patient populations will be required to confirm the racial differences in the clinical characteristics of PTCLs.…”

“…[22][23][24] Moreover, Morabito et al reported that, although the OS curves associated with the Tcell and B-cell immunophenotypes significantly differed from each other (5-year OS, 42% vs. 56% ; median OS, 39 months vs. 94 months, P＝0.0012), multivariate analysis did not detect an association between OS and immunophenotype. 17 It seems likely that we were able to identify immunophenotype as an independent risk factor because we excluded patients with ALCL, which have more favorable outcomes than those with PTCL-u, and we compared nodal PTCLs with nodal DLBCL treated with the same standard CHOP regimen. Moreover, although they were small patient populations, we compared OS among patients with a high IPI index (14 of PTCLs, 10 of DLBCL).…”