Clinico-Epidemiological Presentation and Treatment Outcome of Peripheral T-Cell Lymphoma– Not Otherwise Specified (PTCL-NOS): A Single Institutional Experience

Abstract

Background: Peripheral T-Cell Lymphomas (PTCL) are aggressive malignant lymphoproliferative disorders that represent 10-15% of all non-Hodgkin’s lymphomas (NHL). PTCL- not otherwise specified (PTCL-NOS), comprises approximately 6% of all NHLs, which do not meet the criteria for other mature peripheral T-Cell lymphoma as defined in WHO classification. With limited long-term data evaluating the outcome of PTCL-NOS in the Indian population, we aimed to determine the clinico-epidemiological profile and treatment outcome of patients with PTCL-NOS in a cancer care center from North-East India. Material and Methods: A retrospective observational analysis was performed on the medical records of patients who were diagnosed with PTCL-NOS between January 2015 and December 2018 at Dr. B. Borooah Cancer Institute. Results: Our study evaluated fifty-three patients with PTCL-NOS with the mean age at presentation being 45.3 years (SD ± 16.3 years). The majority of the patients (77.3%) presented with advanced stage (III/IV) with bone marrow involvement in 35.8% of the patients. B-symptoms were present in 58.4% of the patients. Extra-nodal sites of involvement were seen in 64.1% of the patients. The anthracycline-based chemotherapy regimen was the most commonly used in the frontline setting in 71.6% of the patients. Radiation therapy (IFRT) was received by 26.4% of the patients. The overall response rate (ORR) to first-line chemotherapy was 94.3% with complete response (CR) achieved by 62.3% of patients. Twenty-nine (58%) patients had relapsed/ progressive disease. With a median follow-up duration of 38 months, the 3-year progression-free survival (PFS) rate and 3-year overall survival (OS) rate were 27.6% and 33.9% respectively. The median PFS was 22 ± 3.3 months and the median OS was 28 ± 7.1 months.Conclusion: PTCL-NOS is one of the aggressive subtypes of NHL with limited therapeutic options and poor outcomes. Proper treatment adherence and the availability of newer therapeutic options can further enhance the overall outcome.