Analysis of clinical characteristics and prognostic factors for angioimmunoblastic T-cell lymphoma

Abstract

Angioimmunoblastic T-cell lymphoma (AITL) is a distinct peripheral T-cell lymphoma entity exhibiting peculiar clinical features and poor prognosis. Its clinical characteristics and prognostic factors are not well established. To clarify the clinical characteristics and prognostic features of AITL, we conducted a multicenter, retrospective study. Fifty-six patients were enrolled. The median patient age was 68 years. Immunohistochemical examinations of tumor cells showed positivity for CD10 and T-cell markers, and chromosomal examination detected several types of abnormalities. More than 80 % of patients show advanced disease at diagnosis and poor prognostic scores. A high proportion of patients showed accompanying B symptoms, splenomegaly, and hepatomegaly at diagnosis. The 5-year overall survival (OS) rate was 48 % and progression-free survival was 25 %. Univariate analysis revealed higher age, fever, poor performance status, anemia, and low albumin level to be poor prognostic factors for OS. In addition to these factors, both IPI and PIT were also predictive of OS. Multivariate analysis indicated only a low level of serum albumin to be a significant prognostic factor for OS. Serum albumin may be one of the important prognostic factors for AITL. Further investigation is needed to confirm these results.

EBV status has prognostic implication among young patients with angioimmunoblastic T‐cell lymphoma

“…Thrombocytopenia (<150 × 10 9 /mm 3 ) was detected in about 33% of our cases, irrespective of age. Previous reports documented thrombocytopenia in 20%‐40% of patients with AITL; moreover, in a fraction of those patients, thrombocytopenia was related to immune thrombocytopenic purpura . Previous studies also reported an association between thrombocytopenia and poor OS and PFS…”

Expression of the significance of silent information regulator type-1 in Angioimmunoblastic T-cell lymphoma is greater association with tumorigenesis and has strong implications for adverse prognosis

“…However, IPI was not predictive of survival in AITL patients, and a high PIT score was not associated with a good outcome. 2 Histone deacetylase (HDAC) inhibitors are a new class of antitumor agent that is currently undergoing intensive preclinical and clinical testing. Depsipeptides, a member of the 26 Thus, HDAC inhibitors may be useful for treating patients with AITL or other types of cancer in which p53 plays a role, while the efficacy of HDAC class III inhibitors for AITL has not yet been reported.…”

“…Angioimmunoblastic T-cell lymphoma (AITL) is one of the most common forms of peripheral T-cell lymphoma (PTCL) and accounts for approximately 15-20 % of PTCL and 1-2 % of non-Hodgkin's lymphoma. 1,2 AITL generally affects the elderly population, and the median age of patients is greater than 60 y with a slighter greater preponderance in males. AITL is manifested mostly after exposure to medications such as specially antibiotics, viral, bacterial, fungal infection, or an allergic reaction suggesting abnormalities in immune regulation.…”

“…4 Polyclonal hypergammaglobulinemia is also present in 50% of AITL patients. 2 At present, various therapeutic method have been developed, including steroids, cytotoxic chemotherapy, and immunomodulators, although the clinical course of AITL is aggressive and the prognosis of it is still poor. The median survival time is fewer than 3 y with conventional chemotherapies.…”

Clinical characteristics of angioimmunoblastic T-cell lymphoma in China and C-reactive protein as an independent prognostic factor

“…[ 2 – 5 ] Several studies have reported 5-year overall survival (OS) rate of AITL patients ranging from 33% to 48% and 5-year progression-free survival (PFS) rate ranging from 18% to 25%. [ 2 , 4 – 7 ] The International Prognostic Index (IPI) and the prognostic index for PTCL (PIT), have been widely used in patients with various types of non-Hodgkin lymphoma (NHL). However, the application of IPI and PIT scores in AITL are still controversial.…”