Factors predicting survival in peripheral T‐cell lymphoma in the USA: a population‐based analysis of 8802 patients in the modern era

Abstract

SummaryCurrent prognostic models for peripheral T-cell lymphoma (PTCL) have multiple limitations, and questions exist regarding applicability to current patients. We utilized the Surveillance Epidemiology and End Results (SEER)-18 database to evaluate factors affecting overall survival (OS) of PTCL in the modern era and identified 8802 patients between 2000-2010. Most subtypes of PTCL increased in incidence during the study period. In univariate analyses, age >55 years, black race, advanced stage, absence of extra-nodal disease, omission of radiation therapy (RT) and high-risk histology each predicted inferior OS (P < 0Á0001). Multivariate analysis (MVA) demonstrated that hepatosplenic, enteropathy-associated and extranodal Natural Killer/T cell histologies, each had hazard ratios >1Á5 (P ≤ 0Á0001) for death. Further, age ≥55 years, black race and advanced stage maintained their significance in the MVA (P < 0Á0001 each). Based on the significant factors, a prognostic model was constructed and subsequently validated in an independent cohort. The new model incorporated age, stage, histology and race, with an OS ranging from 9 months (highest risk group) to 120 months (lowest risk group). In summary, this is the largest study of PTCL patients in the modern era that provides risk stratification utilizing a new prognostic model that can be incorporated into future prospective clinical trials.

Contributions of Subtypes of Non-Hodgkin Lymphoma to Mortality Trends

“…CHOP is the standard therapy for PTCL ( 51) although new drugs (pralatrexate and romidepsin) received approval in 2009 ( 52, 53). Survival is generally described as poor, although our cancer-specific survival estimate of approximately 65% for PTCL was higher than previously suggested ( 54, 55). We find that 5-year cancer-specific survival for the PTCL cases not otherwise specified was 40%, similar to what is reported in the literature (54, 55).…”

“…Survival is generally described as poor, although our cancer-specific survival estimate of approximately 65% for PTCL was higher than previously suggested ( 54, 55). We find that 5-year cancer-specific survival for the PTCL cases not otherwise specified was 40%, similar to what is reported in the literature (54, 55). Our PTCL classification does include Alk+ T-cell lymphoma, and this also has a low survival rate (5-year survival 52%).…”

Romidepsin for the treatment of relapsed/refractory peripheral T-cell lymphoma: pivotal study update demonstrates durable responses

“…A SEER (Surveillance and Epidemiology End Results) database analysis from 1992 to 2009 showed that, with the exception of ALCL, the incidence of common PTCL subtypes has greatly increased over the past few decades (the combined rate more than tripled from 1992 to 2009) [25]. However, over this same time period, survival times did not increase [25] as they have for patients with B-cell lymphoma [26].…”

“…However, over this same time period, survival times did not increase [25] as they have for patients with B-cell lymphoma [26]. Despite poor outcomes, anthracycline-based regimens continue to be commonly used for the treatment of PTCL [1-3,8-11].…”

Análise do perfil de expressão de genes de proliferação/regulação celular, resposta inflamatória e angiogênese e do padrão de metilação dos genes p15INK4b e p16INK4a em portadores de linfoma de células T periféricas

“…No que se refere à distribuição dos casos por variante histopatológica, assim como demonstrado por outros autores em projetos cooperativos internacionais (International T-cell Lymphoma Project, 2008;FOSS et al, 2011;PETRICH et al, 2014), no presente estudo, prevaleceu o subtipo LCTP/SOE que ocorreu em 34,9% A imunoexpressão da proteína ALK1 é classicamente considerada como variante associada a bom prognóstico, de forma independente no LGCA (GAYSCONE et al, 1999;ten BERGE et al, 2000). Entretanto, estudos recentes demonstraram resultados contraditórios.…”