Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma.

1989 ◽  
Vol 7 (12) ◽  
pp. 1783-1790 ◽  
Author(s):  
J O Armitage ◽  
J M Vose ◽  
J Linder ◽  
D Weisenburger ◽  
D Harrington ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
Complete Remission ◽  
B Cell ◽  
Clinical Significance ◽  
Cell Lymphoma ◽  
Remission Rate ◽  
Stage Iv ◽  
Stage I ◽  
Complete Remission Rate

We performed a prospective study of the clinical significance of immunophenotype in 110 patients with aggressive non-Hodgkin's lymphoma (NHL) treated by oncologists in the Nebraska Lymphoma Study Group between October 1982 and May 1986. All patients were immunophenotyped from biopsies performed before therapy was administered. The patients were treated with a uniform protocol of radiotherapy for minimal nonbulky, stage I or II disease (seven patients) or a single, six-drug chemotherapy regimen cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone (CAP-BOP) in patients with more extensive disease (103 patients). Ninety-one patients (83%) had B-cell lymphoma and 19 patients (17%) had T-cell lymphoma. The histologic diagnosis of diffuse mixed-cell lymphoma was significantly associated with T-cell immunophenotype (45% v 5%; P less than .001), and the diagnosis of diffuse large-cell lymphoma was significantly associated with B-cell immunophenotype (40% v 5%; P = .006). However, no significant difference in frequency of prognostic variables such as age, stage, systemic symptoms, tumor bulk, serum lactic dehydrogenase, or performance status was found between the B-cell and T-cell groups. Patients with B-cell NHL had a slightly higher complete remission rate (74% v 53%; P = NS), similar durability of complete remission (75% v 70% at 3 years; P = NS), and a slightly but not significantly better overall survival (50% v 41% at 3 years; P = NS). The slight advantage in response rate and survival for B-cell patients was related to a very poor outcome for patients with stage IV T-cell NHL. For patients with stage I to III disease, neither the complete remission rate (B-cell, 82% v T-cell, 91%; P = NS) nor overall survival (3-year survival for B cell, 58% v T cell, 73%; P = NS) were significantly different. However, with stage IV disease B-cell patients fared far better than those with T-cell NHL for both complete remission rate (67% v 0%; P = .002) and overall survival (3-year survival, 44% v 0%; P = .002). Immunophenotyping intermediate- and high-grade NHL allowed identification of a subgroup of patients who had a very poor prognosis with this treatment approach and for whom alternate therapy might be considered.

scholarly journals EFS12 Is a Powerful Predictive Tool for Outcomes in Stage I Aggressive Non Hodgkin Lymphoma: A Report from Nationwide Registry in a Resource Limited Country Thai Lymphoma Study Group

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2128-2128
Author(s):  
Kitsada Wudhikarn ◽  
Udomsak Bunworasate ◽  
Jakrawadee Julamanee ◽  
Arnuparp Lekhakula ◽  
Archrob Khuhapinant ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Stage I ◽  
Non Hodgkin Lymphoma ◽  
Resource Limited ◽  
Lymphoma Study Group

Introduction: Stage I disease represents a minor subset of aggressive Non-Hodgkin Lymphoma (NHL) accounting around 10%. Overall prognosis is generally good but varied upon different histologic subtypes and topographic presentation. Herein, we describe an implication of event free survival at 12 months (EFS12) as a predictor for outcomes of stage I aggressive NHL including real-world data on clinical characteristics and treatment patterns of stage I aggressive NHL in a resource-limited country. Patients and methods: Thai lymphoma study group conducted the lymphoma registry which prospectively enrolled and systematically followed newly diagnosed lymphoma patients between 2007 and 2014 from 13 nationwide major University hospitals. We abstracted data of stage I aggressive NHL patients from the registry and obtained additional information from medical record. Clinical characteristics, treatment patterns and survival outcomes were described. EFS12 was a binary endpoint defined as whether patients developed events at 12 months after treatment initiation. Overall survival (OS) was defined as duration from a specific time-point either at the time of diagnosis, at EFS12 time-point to or at the event to death from any causes. Logistic regression model was used to evaluate the association between clinical characteristics and EFS12. Cox regression with EFS12 as a time-dependent co-variate and other clinical parameters were applied to evaluate association between EFS12 and OS. Results: Of 4,371 newly diagnosed lymphomas, there was a total of 636 stage I lymphoma patients (6.86%) including 590 NHL (519 B cell, 71 T/NK cell) and 46 HL. Among 590 stage 1 NHL, 435 were considered patients (356 diffuse large B cell lymphoma (DLBCL) and 8 Burkitt lymphoma (BL), 19 peripheral T cell lymphoma not otherwise specified (PTCL-NOS), 7 angioimmunoblastic T cell lymphoma (AITL), 11 anaplastic large cell lymphoma (ALCL), 1 other PTCL subtypes and 33 extranodal NK T cell lymphoma (ENKTL)). Table 1 summarizes baseline characteristics and treatment data of stage I aggressive NHL. At the time of analysis 61 patients relapsed and 146 patients had died. Major causes of death included infection related events (n=37, 25.3%), non-infectious related complication (n=21, 14.4%) and disease progression (n=60, 41.1%) respectively. With a median follow up of 47.3 months, both median event free survival (EFS) and overall survival (OS) were not reached with corresponding 4 years EFS and 4 years OS of 79.0% and 68.9% respectively (Figure 1A). Four-years OS of patients with aggressive B cell NHL, PTCL and ENKTL was 70.2%, 75.5% and 48.0% respectively. A total of 328 patients achieved EFS12 (No event within the first 12 months after first line treatment initiation). Patients who achieved EFS12 had significant better OS than patients who failed to achieve EFS12 (4-years OS 89.1% vs 7.1%, Hazard ratio 25.9, 95% Confidence Interval 17.7-37.9, P<0.001) (Figure 1C, 1D). Non-relapsed mortality and cumulative incidence of relapse was 15.1% and 19.0% respectively (Figure 1B). By using multivariable cox regression analysis, factors associated with favorable survival outcomes included absence of B symptoms, complete remission from therapy and achieving EFS12 (Table 2). Conclusion: Stage I disease represented a small proportion of aggressive NHL. Natural history and prognosis were highly varied depending upon histology. EFS12 was a power prognostic factor for stage I aggressive NHL and could be used as a clinical tool to stratify patients. Optimal treatment is to be defined to improve outcome and meanwhile minimize toxicities for stage I aggressive NHL patients. Disclosures No relevant conflicts of interest to declare.

Survival of Limited Stage Peripheral T-Cell Lymphoma Is Similar To Diffuse Large B-Cell Lymphoma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2817-2817 ◽  
Author(s):  
Kerry J. Savage ◽  
Mukesh Chhanabhai ◽  
Nicholas Voss ◽  
Shenkier Tamara ◽  
Randy D. Gascoyne ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Free Survival ◽  
Limited Stage ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background: Peripheral T-cell lymphomas (PTCL) represent a heterogeneous group of diseases with an overall poor prognosis. Little information is available regarding the outcome of PTCL patients who present with limited stage disease. We sought to determine the outcome of PTCL patients presenting with limited disease in comparison with a cohort of patients with limited stage diffuse large B-cell lymphoma (DLBCL). Methods: In a retrospective analysis we identified all patients with limited stage (non-bulky (<10cm) stage I/II disease no symptoms) PTCL diagnosed at the British Columbia Cancer Agency (BCCA) between 1983 and 2004. Patients were excluded if they had cutaneous anaplastic large cell lymphoma (CutALCL) (n=13), NK/T-cell lymphoma nasal type (n=9) or primary CNS/ocular involvement (n=6). Results: Thirty-seven patients with PTCL were identified according to the World Health Organization Classification: ALK-neg ALCL 8 (22%); PTCL-unspecified (PTCLUS) 28 (78%); enteropathy associated TCL (EATL) 1 (3 %). The majority received CHOP-type chemotherapy (n=31, 86%), most with brief chemotherapy followed by involved-field radiation (n=19, 61%). The 5 y OS and PFS was similar between PTCLUS and ALK-neg ALCL. There was no difference in survival between extranodal and nodal cases. The outcome of PTCL patients (including ALK-neg ALCL and PTCLUS) was compared to a cohort of limited stage DLBCL patients (excluding CNS/ocular lymphoma) (n=305) diagnosed over the same time period and treated similarly. There was no difference in 5 y OS or PFS (Figure 1,2). Interestingly, there were no late relapses observed in PTCLUS, in marked contrast to DLBCL. Conclusions: Limited stage PTCL is rare, however outcomes appear to be comparable to early stage DLBCL, supporting that they should be treated in a similar manner. Unlike limited stage DLBCL where late relapses occur, a plateau in the progression-free survival curve is observed, highlighting a distinct natural history for limited stage PTCL. Overall Survival Limited Stage PTCL vs DLBCL p=.18 Overall Survival Limited Stage PTCL vs DLBCL p=.18 Progression-Free Survival Limited Stage PTCL vs DLBCL p=.07 Progression-Free Survival Limited Stage PTCL vs DLBCL p=.07

Comparative Outcomes of Chemotherapy with and without HAART for HIV-Related B-Cell Lymphoma: A Meta-Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4372-4372 ◽  
Author(s):  
Matthew J Ehrhardt ◽  
Janaki Y Shah ◽  
Yachiyo Kuwatsuka ◽  
Sailaja Kamaraju ◽  
Jeffrey L Jackson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Viral Load ◽  
Complete Remission ◽  
B Cell ◽  
Random Effects ◽  
Median Survival ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Cochrane Central Register

Abstract Background Human immunodeficiency virus (HIV) infected individuals have an increased incidence of malignancies, including B-cell lymphomas. The use of highly active antiretroviral therapy (HAART) during antineoplastic therapy for HIV related lymphoma remains controversial. The current meta-analysis investigates the impact of the upfront addition of HAART to chemotherapy on overall survival (OS) compared to chemotherapy alone. Methods We searched MEDLINE (January 1996 to May 2013), the Cochrane Central Register of Controlled Trials (May 2013), and the references of retrieved articles. Published clinical trials were included that both clearly defined the patients treated with and without HAART and provided the respective outcomes for each group. Two authors independently assessed the quality of studies and abstracted data. Primary outcomes were complete remission (CR) and overall survival (OS). Hazard ratios were pooled using random effects methods. Heterogeneity was assessed with I2 and by visual inspection of the Galbraith plots. Sources of heterogeneity were explored using stratified analysis and random-effects meta-regression. Results Four retrospective chart reviews, one retrospective case control, two cohort studies, one randomized trial, and two prospective trials were eligible for review, providing 1070 subjects with an average age of 41.3 years. The mean CD4 count was 223/μl and HIV viral load 192,452 copies/ml. There was significant heterogeneity between studies. Individuals receiving HAART were more likely to achieve CR compared to those not receiving HAART (RR 1.47, CI: 1.04-2.06, I2=75.0%). Among those receiving HAART, 56% (95% CI: 45%-67%, I2=67.8%) achieved CR compared to 37% (95% CI: 28%-45%, I2=75.1) not receiving HAART. The addition of HAART to chemotherapy improves OS when compared to those receiving chemotherapy alone (HR: 0.58, 95% CI: 0.49-0.68, I2=91.4%, Figure 1), representing an increased median OS time of 20.5 months (95% CI: 2.6-38.4, I2=93.6%). Calculation of a pooled HR using survival curve data from studies with extractable data yielded similar results (HR: 0.50, 95% CI: 0.41-0.61, Figure 2). Higher CD4 counts were associated with improved survival (p<0.0005). Conversely, older age (p=0.017), higher viral load (p<0.0005), higher stage lymphoma (p=0.023), the presence of B-symptoms (p<0.0005), and worse functional status (p<0.0005) were associated with decreased survival. Following adjustment for these predictors, concurrent HAART and chemotherapy resulted in improved OS (HR: 0.46, 95% CI: 0.38-0.57). There was no evidence of publication bias for any of our outcomes (CR: p=0.39, median survival: p=0.47, HR: p=0.07). There was also no relationship between quality and any of our outcomes (CR: p=0.77, median survival: p=0.32, HR: p=0.33). Conclusion Overall survival and complete remission are improved with the upfront addition of HAART to chemotherapy when compared to chemotherapy alone for patients with HIV related B-cell lymphoma. Disclosures: No relevant conflicts of interest to declare.

A Retrospective Cohort Study to Evaluate the Outcomes of HIV-Associated High-Grade B-Cell Non-Hodgkin Lymphoma (NHL) Treated with Dose Adjusted R EPOCH Regimen

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4213-4213
Author(s):  
Hasmukh Jain ◽  
Manju Sengar ◽  
Hari Menon ◽  
Tanuja Shet ◽  
Epari Sridhar ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
B Cell ◽  
Cell Count ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Cd4 T Cell ◽  
Survival Outcomes ◽  
High Grade ◽  
Cd4 T Cell Count

Abstract Background- High grade B-cell NHL's are 200 fold more common in seropositive as compared to seronegative patients. It includes diffuse large B cell lymphoma (DLBCL) (50%), Burkitt's (BL)(40%) and others such as plasmablastic lymphoma(PBL). They are biologically different from their seronegative counterparts with higher incidence of extranodal involvement, advanced stage and poor response to conventional therapy. In addition, they are at a higher risk of chemotherapy side effects and poorly tolerate dose intense regimens. To add to the complexity, social stigma and financial constraints decrease the compliance to therapy. R-EPOCH is designed to provide a balance between efficacy and safety. We report on our cohort of patients who were treated with this protocol. Methods- We retrospectively analysed HIV-associated de-novo high grade B-cell NHL patients who were treated with R EPOCH regimen at Tata Memorial Centre from 2011 till 2015. Patients aged ≥18 years who had received at least 1 cycle were included in the analysis. R EPOCH is an infusional regimen in which the dose of cyclophosphamide is adjusted depending on the baseline CD4+ T cell count and tolerance. The primary objective was the 3-year overall survival(OS), secondary objectives were response rates, the incidence of grade3/4 toxicities, dose intensity and correlation of OS with CD4 count, IPI, duration of HIV, Cyclophosphamide dose intensity (CDI). Demographic features, HIV related details (CD4 count at diagnosis, ART regimen), histological diagnosis, stage, bulky disease, extranodal sites, treatment details (number of cycles, dose administered), response, toxicity and status at last follow up were recorded. Descriptive statistics were summarised with median and range, survival outcomes were analysed with Kaplan meier method and impact of CD 4 count, CDI, IPI and duration of HIV on survival was assessed using log rank test. Results- A total of 40 patients(31males) with a median age-40 years (24-65 years) were treated. B symptoms were present in 19(48%). The cohort comprised of DLBCL-19 (48%), BL-16(40%), High grade B-Cell Lymphoma-Unclassifiable-4 (10%) and PBL 1 (2.5%). 16 (40%) patients had co-morbidities, including co-existent Hepatitis C in 5 and Hepatitis B in 2. HIV infection was detected at the time of lymphoma diagnosis in 18 (45%). The median CD4+ T cell count was 202 cells/mm3, 6 patients (15%)had count of <100/mm3 All patients received HAART while on chemotherapy, NNRTI plus 2 NRTI combination being the commonest regimen-33(82%) patients. Performance status (ECOG) ≤2 was seen in 36(90%) patients. 38 (95%) had stage III/IV disease and bulky disease (defined as size ≥7cm) was seen in 29(72%) patients. Extranodal involvement was seen in 36(90%) patients. Haemoglobin level ≤11g/dL in 10(25%) patients (range- 8.2-15.6 g/dL), serum albumin <4g/dL in 23(58%) patients, serum LDH ≥ upper normal limit -38 (95%)patients. Atleast 4 cycles of chemotherapy were administered to 35 (93%)patients, with 28 (70%) receiving 6 cycles. Cyclophosphamide dose escalation was possible in 18(45%) patients. CNS prophylaxis was administered with intrathecal methotrexate (median number-6) to 36(90%) patients. High dose methotrexate was given to 5 patients. Rituximab was not administered to 5 patients (3 due to CD4 count <100, 2 due to CD20 negativity). Responses were assessed using 18FDG PET-CT scan with complete response-32(80%), partial response-1(3%), disease progression-4(10%) and not evaluable- 4 (7%). Grade ¾ toxicities were seen in 33(83%) patients, with febrile neutropenia-26(65%), mucositis-10(25%) and peripheral neuropathy in5(13%) patients. Out of the 210 cycles administered, there were 41(20%) episodes of hospitalisation (duration ranged from 2-51 days). There were 11(28%) deaths (progression-7, toxicity-2, Not known-2) and 7(18%) patients had progression (4- on treatment progression, 3- relapses). With a median follow-up of 29 months, estimated 3-year OS is 71% (Figure 1) and 3-year progression free survival is 79%. There was no difference in survival based on IPI, CD 4+ T cell count, CDI or duration of HIV. Conclusions- R-EPOCH is a highly effective regimen in seropositive high-grade B-cell lymphoma even in the presence of adverse features (advanced stage, extranodal sites, CNS involvement, low CD4+ T cell count). The emphasis should now be on further reducing the toxicities. Figure Overall survival outcomes Figure. Overall survival outcomes Disclosures No relevant conflicts of interest to declare.

scholarly journals Elevated LDH greater than 400 U/L portends poorer overall survival in diffuse large B-cell lymphoma patients treated with CD19 CAR-T cell therapy in a real world multi-ethnic cohort

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Rabinovich ◽  
Kith Pradhan ◽  
R. Alejandro Sica ◽  
Lizamarie Bachier-Rodriguez ◽  
Ioannis Mantzaris ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lactate Dehydrogenase ◽  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Therapy ◽  
A Value ◽  
Large B Cell Lymphoma ◽  
Large B Cell

AbstractAnti-CD19 chimeric antigen receptor T-cell therapies have shown striking clinical activity in diffuse large B-cell lymphoma but robust biomarkers predictive of responsiveness are still needed. We treated a multi-ethnic cohort of 31 diffuse large B-cell lymphoma patients with axicabtagene ciloleucel with an overall response rate of 71%. Analysis of various biomarkers identified a significant decrease in overall survival with elevated lactate dehydrogenase, measured both at time of cell infusion and before lymphodepletion. Lactate dehydrogenase was prognostic in a multivariate analysis [HR = 1.47 (1.1–2.0)] and a value of 400 U/L at time of infusion and a value of 440 U/L before lymphodepletion provided the best prognostic cutoffs for overall survival in our cohort. These data demonstrate efficacy of anti-CD19 chimeric antigen receptor T-cell therapy in a diverse inner city population and demonstrate novel lactate dehydrogenase cutoffs as prognostic biomarkers.

scholarly journals Distinct Molecular Subtypes of Diffuse Large B Cell Lymphoma Patients Treated with Rituximab-CHOP Are Associated with Different Clinical Outcomes and Molecular Mechanisms

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Haifeng Yu ◽  
Shuailing Peng ◽  
Shuiyun Han ◽  
Xi Chen ◽  
Qinghua Lyu ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
B Cell ◽  
Molecular Mechanisms ◽  
Molecular Subtypes ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Training Set ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Objective. Our purpose was to characterize distinct molecular subtypes of diffuse large B cell lymphoma (DLBCL) patients treated with rituximab-CHOP (R-CHOP). Methods. Two gene expression datasets of R-CHOP-treated DLBCL patients were downloaded from GSE10846 ( n = 233 , training set) and GSE31312 ( n = 470 , validation set) datasets. Cluster analysis was presented via the ConsensusClusterPlus package in R. Using the limma package, differential expression analysis was utilized to identify feature genes. Kaplan-Meier survival analysis was presented to compare the differences in the prognosis between distinct molecular subtypes. Correlation between molecular subtypes and clinical features was analyzed. Based on the sets of highly expressed genes, biological functions were explored by gene set enrichment analysis (GSEA). Several feature genes were validated in the molecular subtypes via qRT-PCR and western blot. Results. DLBCL samples were clustered into two molecular subtypes. Samples in subtype I displayed poorer overall survival time in the training set ( p < 0.0001 ). Consistently, patients in subtype I had shorter overall survival ( p = 0.0041 ) and progression-free survival time ( p < 0.0001 ) than those in subtype II. Older age, higher stage, and higher international prognostic index (IPI) were found in subtype I. In subtype I, T cell activation, lymphocyte activation, and immune response were distinctly enriched, while cell adhesion, migration, and motility were significantly enriched in subtype II. T cell exhaustion-related genes including TIM3 ( p < 0.001 ), PD-L1 ( p < 0.0001 ), LAG3 ( p < 0.0001 ), CD160 ( p < 0.001 ), and CD244 ( p < 0.001 ) were significantly highly expressed in subtype I than subtype II. Conclusion. Two molecular subtypes were constructed in DLBCL, which were characterized by different clinical outcomes and molecular mechanisms. Our findings may offer a novel insight into risk stratification and prognosis prediction for DLBCL patients.

Clinical Outcomes of Patients with T Cell NHL Undergoing Allogeneic Stem Cell Transplant.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3026-3026 ◽  
Author(s):  
Jasmine Zain ◽  
J. Palmer ◽  
N. Tsai ◽  
L. Popplewell ◽  
A. Nadamanee ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
B Cell ◽  
Sample Size ◽  
Clinical Outcomes ◽  
Cell Lymphoma ◽  
Progression Free Survival ◽  
T Cell Lymphoma ◽  
Cell Transplant ◽  
Free Survival

Abstract Background: T cell NHL represent approximately 10–15% of all lymphomas. Pts with T cell NHL are often treated similarly to patient with B cell NHL, although the clinical outcomes of most patients with T- NHL tend to be worse with the exception of ALK positive anaplastic large cell lymphomas (ALCL). Updated classifications in recent years have recognized specific clinical and pathologic T cell entities with distinct clinical courses and this poses a challenge to the systemic study of these diseases. The exact role of allogenic transplant in T- cell NHL is unknown. Methods: We looked at 45 pts who underwent an allogeneic HSCT for T cell lymphomas between Jan 2000 to Dec 2005. There were 18 males, 27 females. Median age at transplant was 32 (7–74). Histology was Mycosis fungoides /Sezary syndrome (SS/MF) n=10, T cell lymphobalstic leukemia (PTLL) n=16, PTCL including AILD and ALCL n=14, NKT cell n=5. Syngeneic donor 1, Sibs 31, MUD 13. Median time from diagnosis to transplant was 12.5 (3.6–88.3) mo. Source of stem cells BM 9, PBSCT 35, cord blood 1. Conditioning, fully ablative 29, reduced intensity 16. Median number of prior regimens MF/SS 5, PTLL 2, PTCL 3, NKTL 2 with only 2 pts with prior auto transplants. 18 pts were in remission at the time of transplant and 12 pts had induction failure. Results: Median follow up from transplant was 45.3 mo(0.7–64.7) with a 55.6%OS. Incidence of GVHD was Acute n= 27 extensive chronic n=20. Cause of death was transplant related in 16 pts with only 3 pts dying of disease progression. The overall survival is 61.2 % at 1 year,55.4% at 2 years and 48.5% at 5 years with a 5 year progression free survival at 48.5%. Based on different histologies, the results are 50.0% overall survival at 1 year and 40.0% at 2 and 5 years for SS/MF, 55.6% at 1 and 2 years for PTLL, 70.1% at 1 and 2 years and 52.6% at 5 years for PTCL and 80% at 1 year for NKT shown in fig 1 and 2. Conclusion: Allogenic transplant can result in long term survival for some patients with T cell NHL suggesting a graft vs lymphoma effect. Timing of transplant needs to be better defined. Most patients are heavily pretreated which may have resulted in more transplant related mortality with 11/20 pts dying of infection. Most patients did not have a prior auto transplant indicating early progression of disease after standard therapies defined for B cell malignancies. Overall Survival by Histology
 T-Cell Lymphoma with Allogenic Transplant
 Sample Size: 45 patients Overall Survival by Histology
 T-Cell Lymphoma with Allogenic Transplant
 Sample Size: 45 patients Progression-Free Survival by Histology
 T-Cell Lymphoma with Allogenic Transplant
 Sample Size: 45 patients Progression-Free Survival by Histology
 T-Cell Lymphoma with Allogenic Transplant
 Sample Size: 45 patients

Cutaneous Lymphomas: Single Institution Experience in Lima-Peru.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4619-4619
Author(s):  
Brady E. Beltrán-Gárate ◽  
José Malaga ◽  
Karen Portugal ◽  
Domingo Morales ◽  
Luis Riva ◽  
...  
Keyword(s):  
Overall Survival ◽  
T Cell ◽  
B Cell ◽  
General Hospital ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Cutaneous Lymphomas ◽  
Large B Cell

Abstract Background: The clinicopathologic characteristics of malignant lymphomas may vary according to geography. We previously described Adult T -cell leukaemia/lymphoma (ATLL) cases associated with human T-cell lymphotropic virus type-I (HTLV-I) in their different clinical presentation: acute, lymphomatous, chronic and smoldering and the recently primary cutaneous subtype in Peru (EHA2001: abstract 129). The aim of this study is to determine the relative frequency of cutaneous lymphomas and evaluate the clinical relevance of the new WHO/EORTC classification in a General Hospital in Lima-Peru Methods: We conducted a clinicopathologic retrospective study of primary cutaneous lymphomas diagnosed from 1997 to 2004 in our General Hospital. Clinical records, haematoxylin & eosin-stained slides and immunohistochemical stains from 78 patients were reviewed. HTLV-1 serology was made using ELISA and Western Blot method. The statistical method was descriptive and survival was calculated using the Kaplan-Meier method. Results: The mean age at time of presentation was 62 years and the female/male ratio 1,5:1. T-cell lymphomas were 88.6% and 11.4% were B-cell lymphomas. Eight-six percent (67/78) were primary cutaneous lymphomas and fourteen percent (11/78) were secondary cutaneous lymphomas. The most frequent primary cutaneous lymphomas was mycosis fungoides (MF): 44.7% (30/67); cutaneous / smoldering ATLL sutypes included 13/67 (19.4%) patients; unspecified peripheral T-cell lymphoma 4/67 (6%), lymphomatoid papulosis 2/67 (3%), leg-type diffuse large B-cell lymphoma 2/67 (3%), diffuse large B-cell lymphoma 2/67 (3%), subcutaneous panniculitis-like T-cell lymphoma 2/67 (3%), one case of the following lymphomas: anaplastic large cell, Sézary syndrome, nasal type extranodal NK/T-cell lymphoma, marginal zone B-cell lymphoma, follicle center lymphoma and intravascular lymphoma; finally unclassifiable lymphomas 5/67 (7.4%). Most frequent secondary cutaneous lymphomas were acute and lymphomatous subtypes of ATLL with 72% of the cases. Five-years overall survival for MF was 77%. The 5-years overall survival for primary cutaneous ATLL lymphomas was 18% and 0% for the secondary cutaneous ATLL group. Conclusions: In this retrospective analysis, both ATLL and MF are the most frequent cutaneous lymphomas in our General Hospital. ATLL has a poor overall survival.

Radiation Therapy In Peripheral T-Cell Lymphoma Of The Head and Neck

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1795-1795 ◽  
Author(s):  
Annemarie T. Fernandes ◽  
Jakub Svoboda ◽  
Sunita D. Nasta ◽  
Lynn D. Wilson ◽  
John P. Plastaras
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
T Cell ◽  
Marital Status ◽  
Head And Neck ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Stage I ◽  
Peripheral T Cell Lymphoma ◽  
Stage Disease

Abstract Introduction The role of radiation therapy in peripheral T-cell lymphoma (PTCL) is not well established. While the NCCN guidelines recommend combined modality treatment with consolidative radiation therapy after chemotherapy for localized (stage I and II) disease, the data supporting this recommendation is lacking and is extrapolated from B-cell lymphoma. Methods This is a retrospective analysis of outcome in patients with non-cutaneous peripheral T-cell lymphoma of the head and neck from the Surveillance, Epidemiology and End Results (SEER) database diagnosed between 1981-2010. Survival was estimated by Kaplan-Meier estimates using the log-rank test. Univariate and multivariable analyses were performed using Cox regression analysis. Results Of the 307 patients analyzed, 130 (43%) underwent radiation therapy. The median age was 59 years old, 60.3% were male, 73.9% were Caucasian and the median year of diagnosis was 2004. The majority of patients had PTCL, Not Otherwise Specified (74.3%), followed by anaplastic large cell histology (22.2%). Patients were grouped as stage I (47.2%), stage II (29.9%) and stage III/IV (22.8%). Head and neck sites included the nasal cavity (28.3%), oropharynx (25.7%), oral cavity (21.2%), salivary gland (11.7%), nasopharynx (7.8%) and larynx/hypopharynx (5.2%). The median follow-up was 54 months for survivors. Radiation therapy was associated with a higher 5-year overall survival in all patients (56.7% vs. 38.4%, p=0.001), patients with stage I disease (63.4% vs. 53.4%, p=0.036) and patients with stage II disease (60.8% vs. 36.3%, p=0.034), see Figure 1. Radiation therapy was not associated with a difference in overall survival in patients with stage III/IV disease (p=0.91). Univariate analysis demonstrated that age, stage, radiation therapy and marital status were predictive of overall survival, but sex, and race were not. The year (p=0.93) or decade of treatment (p=0.67) did not impact overall survival. On multivariable analysis, increasing age (HR: 1.02, p<0.001), increasing stage (HR: 1.42, p=0.004), radiation therapy (HR: 0.60, p=0.011) and marital status of not married (HR: 1.49, p=0.035) remained statistically significant predictors of overall survival. An additional analysis was performed excluding patients who survived less than 3 months to account for mortality related to disease progression or chemotherapy toxicity. After excluding these 45 patients, radiation therapy was still associated with increased overall survival in all patients (p<0.001) and in patient with limited stage disease (p=0.021). Conclusions The integration of local radiation therapy to the treatment of PTCL of the head and neck may improve overall survival in patients with limited stage disease. Disclosures: No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document