ANALYSIS OF PATIENTS IN THE FIRST RELAPSE OR PROGRESSION OF T‐CELL LYMPHOMA. REAL WORLD DATA FROM CZECH LYMPHOMA STUDY GROUP REGISTRY (NIHIL).

Abstract

Background: Systemic T-cell lymphoma (TCL) is heterogeneous group of hematological malignancies with extremely poor prognosis. The prognosis of relapsed/ progressed disease is much worse, but there are sporadic data about this group of patients only. We focused on the most frequent subsets ALCL, PTCL-NOS and AITL/TFH-TCL) representing around 70% of all systemic T-cell lymphoma. Methods: For this analysis, ALCL, PTCL-NOS and AITL patients at first progression (n = 441) were selected from the NIHIL registry (initial diagnosis 1999-2021). We tried to characterize this group of patients by calculation of PFS, OS, OS2 and interval from-relapse-to-therapy. We compared the subgroup of patients with early vs. late progression. Results: At the first relapse (R1), there were 117 (26.5%) ALCLs, 74 (16.8%) AITLs, and 250 (56.7%) PTCLs, median age was 63 yrs (range; 19-91); 274/441 (62%) were men. First-line therapy included CHOP (254; 57.6%), CHOEP/CEP (110; 24.9%), and 52 (11.8%) pts were autotransplanted. Median since diagnosis to R1 was 0.72 yrs (range; 0.3–15.2), median OS2 from progression was 0.41 yr (0–10.28). Majority of patients 293/441 (66%) progressed early within 1 year including 168 (57%) of primary progression, whereas 58 (13%) pts only relapsed 2.5 years or later, remaining 90 (20%) pts relapsed between 1 and 2.5 years. Patients with early relapse (<1 year) with median age (61 yrs), 65% were men, median OS2 was 0.31 year (0-8.9); median interval from-relapse- to-therapy was 8 days (range; 0-370). The most frequent therapy administered in R1 were platinum-based (28%) a gemcitabine-based (16%) regimen, 40 (13.6%) pts were transplanted (including 20 alloTx); whereas 26% patients did not start any therapy. Patients with late relapse (≥2.5 years) had median age 65 yrs, 55% were men, OS2 was longer with median 0.97 year (range; 0.05-10.2); median interval from-relapse- to-therapy was longer with median 34 days (range; 0-273). The patients were treated by gemcitabine (28%) and platinum-based regimens (22%), whereas 17% patients were not treated at all, autoTx was administered in 14% cases. Conclusions: Our analysis demonstrates that relapse of TCL is usually fatal event for majority of patients with very short survival (in order of months), which occurs very early (in two thirds of pts within 1 yr since diagnosis). Because of lack of data from big clinical trials, these results could serve as a supporting evidence for administration of case-driven targeted therapy. Conflicts of interests pertinent to the abstract Keywords: Aggressive T-cell non-Hodgkin lymphoma, Non-Hodgkin (Pediatric, Adolescent, and Young Adult) D. Belada Consultant or advisory role Gilead, Roche, Novartis, Takead Educational grants: Roche, Gilead Sciences H. Mocikova Consultant or advisory role Takeda, Roche, Astra Seneca, Janssen, Abbvie Educational grants: Janssen, Takeda J. Duras Consultant or advisory role Roche, Takeda, Celgene