Peripheral T-cell lymphomas have a worse prognosis than B-cell lymphomas: A prospective study of 361 immunophenotyped patients treated with the LNH-84 regimen

Abstract

The prognostic significance of phenotype in malignant lymphomas (ML) is a matter of controversy. Here we analyze the clinical presentation, response to treatment, and survival of the 361 phenotyped patients with ML who were treated by the LNH-84 regimen. Histologic subtypes were diffuse-small cell in 10 patients, diffuse mixed in 69, diffuse large-cell in 177, immunoblastic in 94, and anaplastic large-cell in 11. One hundred and eight patients (30%) had a peripheral T-cell ML and 253 (70%) a B-cell ML. Most of B-cell MLs were of diffuse large-cell type, and the T-cell MLs were distributed among diffuse mixed and immunoblastic subtypes. T-cell MLs had an aggressive presentation with more patients having advanced stage (21% versus 41% stage II, 53% versus 45% stage IV, p = .0002), and B symptoms (58% versus 42%, p less than .01). The only significant difference in clinical manifestations were the higher frequency of gastrointestinal involvement in B-cell MLs (20% versus 2%, p less than .0001) and the more frequent spleen (39% versus 21%, p = .0005) and skin (19% versus 3%, p less than .0001) involvement in T-cell MLs. There was no difference in response to the LNH-84 regiment between the two subgroups, but T-cell ML patients relapsed at a higher rate (43% versus 29%, p less than .001). T-cell ML patients have a significantly shorter freedom-from-relapse (FFR) survival (median: 34 months versus not reached, logrank test: p = .002) and a non-significant shorter overall survival (median: 42 versus 50 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term outcomes of autologous PBSCT for peripheral T-cell lymphoma: retrospective analysis of the experience of the Fukuoka BMT group

“…4,5 Compared with aggressive B-cell NHL, the prognosis of PTCL patients is considerably poorer if they are treated with CY, doxorubicin, vincristine and prednisone (CHOP) or CHOP-like regimens. 6,7 Survival advantage of HDCT with auto-SCT for PTCL patients is contentious because most studies have involved small series and short-term follow-up. [8][9][10] Since 1990, in Fukuoka Blood and Marrow Transplantation Group (FBMTG), HDCT with autologous PBSCT (auto-PBSCT) has been evaluated as consolidation for patients in CR1 or partial response (PR) 1, and as salvage for patients with relapsed and refractory disease, to improve PTCL outcomes.…”

The role of high-dose therapy and stem cell rescue in the management of T-cell malignant lymphomas: a BSBMT and ABMTRR study

“…1 PTCLs are a rare and heterogeneous group of malignant disorders and most studies demonstrate a poorer prognosis associated with T-cell compared with B-cell phenotype, with T-cell phenotype being previously demonstrated to be an independent adverse risk factor in all groups except for anaplastic lymphoma kinase-positive tumours. [2][3][4][5] Patients with PTCL treated with conventionaldose chemotherapy alone, demonstrated a 5-year survival of 38% (95% confidence interval (CI), 35-54%) compared to patients with B-cell disease who demonstrated a 5-year survival of 63% (95% CI 53-73%, P ¼ 0.001), a difference that was maintained when stratified using the IPI and MD Anderson tumour score. 4,6 Cumulative experience has shown that high-dose chemotherapy is an effective salvage therapy in B-cell malignant lymphoma.…”

High-dose therapy with autologous stem cell transplantation in patients with peripheral T cell lymphomas

“…1,2 PTCL are generally described as aggressive with disseminated disease at diagnosis and poor survival when treated with the same regimens as high-grade B cell lymphomas. [3][4][5][6][7][8] However, PTCL are a heterogeneous group of lymphomas whose aggressiveness may vary depending on subtype. Anaplastic large cell lymphomas (ALCL) constitute a subgroup of PTCL with better response to treatment and overall survival.…”