Impact of comorbidity in older patients with peripheral T-cell lymphoma: an international retrospective analysis of 891 patients

Abstract

Peripheral T cell lymphoma (PTCL) is a heterogeneous group of aggressive neoplasms with poor outcomes, commonly affecting elderly patients with comorbidities. This study aims to describe outcomes of elderly PTCL patients in a large international cohort. Patients aged ≥ 70 years with PTCL diagnosed from January 1, 2010 - December 31, 2015 in the Swedish Lymphoma Registry (SLR) and California Cancer Registry (CCR) were identified. Data on comorbidity were retrospectively collected according to the Charlson Comorbidity Index (CCI) and clinical outcomes were extracted. 891 patients were included (SLR, n = 173, CCR, n = 718). Median age was 77 (SLR) and 78 (CCR) years. Included subtypes were AITL, n = 226; ALCL, n = 122; EATL, n = 31; Hepatosplenic TCL, n = 7; NK/T-cell lymphoma, n = 62; and PTCL NOS, n = 443. CCI data was available in 775 patients (87 %), and CCI scores were divided into the groups CCI = 0 (39 %), CCI = 1 (22 %) and CCI > 1 (39 %). Median age did not differ between the CCI groups (p = 0.72). Patients with a CCI > 1 had a worse median overall survival (OS) (4.4 months) compared to patients with CCI = 0 (11.9 months) and CCI = 1 (8.4 months), p < 0.001. Comorbidity and advancing age in as little as 5-year increments are important adverse factors in this group. The majority of patients died of lymphoma within a year from diagnosis, underscoring the importance of developing new treatments.

Chidamide in combination with azacitidine for an elderly patient with peripheral T cell lymphoma‑not otherwise specified: A case report

“…Relapsed/refractory PTCL-NOS has median EFS and OS typically <6 months (22,23). Considering the adverse factors of age and comorbidities, this highlights the importance of developing new therapies, especially for elderly patients who may be intolerant to chemotherapy (24). To address the recurrent epigenetic changes in PTCL, histone deacetylase inhibitor (HDACi) and hypomethylating agents (HMA) are employed in the treatment of PTCL.…”

Phase II Trial of Romidepsin as Consolidation Therapy after Gemcitabine, Dexamethasone, and Cisplatin in Elderly Transplant-Ineligible Patients with Relapsed/Refractory Peripheral T-Cell Lymphoma

“…Older age is reportedly associated with a poor prognosis among patients with PTCL, including PTCL-NOS and AITL [ 21 ]. This is believed to be associated with the increased risk of treatment-related mortality in older patients.…”

Retrospective Analysis With Propensity Score Matching of Peripheral T-Cell Lymphoma Treated Frontline With Brentuximab Vedotin and Chemotherapy

“… 14 This is relevant with PTCL, where >50% of patients are aged ≥62 years at diagnosis, and among patients aged ≥70 years with PTCL, comorbidities are common, with 35%-40% of these patients having a Charlson Comorbidity Index (CCI) score of ≥2. 15 , 16 In addition, as PTCLs are rare, with large subtype heterogeneity, subtype analyses in RCTs are challenging due to small sample sizes.…”