Long term outcome of Peripheral T Cell Lymphomas: 10y follow‐up analysis of the International Prospective T Cell Project Network

Abstract

Introduction: Peripheral T cell lymphomas (PTCLs) are a rare, heterogeneous group of hematological malignancies with too often poor prognosis for almost all subtypes. The T-Cell Project (TCP; registered at clinicaltrials.gov identifier: 01142674) was a prospective cohort study aimed at better understanding clinical characteristics and outcome of patients with PTCL. Here we report the results of 10-year follow up, focused on late relapses and long term survival. Methods: The TCP started in September 2006 as a prospective registry of patients with mature PTCLs. Between December 2006 and March 2018, 1669 patients were registered and 1,553 patients were eligible in the study. Recently, a survey was launched asking for the willingness of the centers to provide long term follow up data. So far, out of 1,553 eligible patients, 713 were referred by Centers that provided information on long-term follow-up and have been included in the present analysis; 840 cases, referred by centers that did not participate to this long term survival analysis were excluded. However, both groups showed similar baseline characteristics and 5y OS (44% vs. 44%) and PFS (37% vs. 35%), thus minimizing selection biases Result: Out of these 713 patients, 255 patients (36%) had a diagnosis of PTCL NOS, 133 (19%) of AITL, 124 (17%) of ALCL ALK-, 62 (8%) of ACL ALK- and 13 (2%) of NKTCL. The median age at diagnosis was 56 years (range, 18–88 years), with a slight male predominance (55%). B symptoms were present in 44% and extranodal involvement in 56% of patients. Patients receiving chemotherapy alone and radiotherapy alone comprises 58% and 3% respectively; while the 18% received CHT+RT. Of evaluable patients, 60% received anthracycline-based chemotherapy, 24% anthracycline/etoposide and 12% etoposide alone. A minority (16%) of the total cohort underwent high-dose chemotherapy with autologous stem cell support as first-line consolidation. After a median follow-up of 82 months, 35 (12%) of patients had an event of progression or death beyond 5 years. The 5- and 10-year rates of both overall survival and progression-free have decreased from 44% and 40%, to 31% and 27%, respectively (Figure 1). For those patients alive at 5 years, the chance of surviving the subsequent 5 years was 83% (95% CI: 61–99). Furthermore, for patients progression free at 5 years the probability of being disease alive and free in the subsequent 5 years was 78% (95% CI: 60–96). Ten year OS and PFS rates for patients alive at 5 years were: 77% and 73% for PTCL NOS, 85% and 76% for AITL, 88% and 87% for ALCL ALK-, 100% and 100% for ALCL ALK+), and 78% and 80% (for NKTCL). Keyword: aggressive T-cell non-Hodgkin lymphoma No conflicts of interests pertinent to the abstract.