Survival of Patients With Peripheral T-Cell Lymphoma After First Relapse or Progression: Spectrum of Disease and Rare Long-Term Survivors
Survival of Patients With Peripheral T-Cell Lymphoma After First Relapse or Progression: Spectrum of Disease and Rare Long-Term Survivors
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DOI：
10.1200/jco.2012.44.7524
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发表时间：
2013-06-01
影响因子：
45.3
通讯作者：
Savage, Kerry J.
中科院分区：
文献类型：
--
作者：
Mak, Vivien;Hamm, Jeremey;Savage, Kerry J.
引言一些新的治疗方法正在研究中的复发性或难治性外周T细胞淋巴瘤（PTCL），然而，他们的相对影响的结果是未知的。我们研究了PTCL患者在没有造血干细胞移植的情况下复发或进展后的生存率，并探讨了影响生存率的因素。评估了北美最常见的三种亚型：PTCL未另行说明（PTCL-NOS）、血管免疫母细胞性T细胞淋巴瘤（AITL）和间变性大细胞淋巴瘤患者和方法排除后，分析了153例患者（PTCL-NOS，n = 79 [52%]; AITL，n = 38 [25%]; ALK阳性ALCL，n = 11 [7%]; ALK阴性ALCL，n = 27 [16%;包括ALK状态未知，n = 1]）.ResultsMedian time from initial diagnosis to relapse or progression after primary therapy was 6.7 months，and median age at relapse was 66 years（ALK阳性ALCL，39 years）.复发或进展后的中位总生存期（OS）和中位无进展生存期（PFS）（第二个PFS）分别为5.5和3.1个月，仅在复发时接受化疗的患者中略好（n = 89 [58%];分别为6.5和3.7个月）。复发时体能状态良好（PS）为0或1的患者（n = 47）接受化疗的OS更有利（P < .001;中位OS，13.7个月）和PFS（P = 0.006;中位第二个PFS，5.0个月），在多变量分析中仍具有显著性（OS：危险比[HR]，2.09; P = 0.002;第二次PFS：HR，1.66; P = 0.030）.结论大多数复发或难治性PTCL患者预后差，生存期短。选择PS良好的患者进行标准化疗具有更有利的结局。(c)2013年美国临床肿瘤学会
IntroductionA number of novel therapies are under investigation in relapsed or refractory peripheral T-cell lymphoma (PTCL); however, their relative impact on outcome is unknown. We examined the survival of patients with PTCL after relapse or progression in the absence of hematopoietic stem-cell transplantation and explored factors influencing survival. The three most common subtypes encountered in North America were evaluated: PTCL not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic large-cell lymphoma (ALCL; anaplastic lymphoma kinase [ALK] positive and ALK negative.Patients and MethodsAfter exclusions, 153 patients were analyzed (PTCL-NOS, n = 79 [52%]; AITL, n = 38 [25%]; ALK-positive ALCL, n = 11 [7%]; ALK-negative ALCL, n = 27 [16%; including ALK status unknown, n = 1]).ResultsMedian time from initial diagnosis to relapse or progression after primary therapy was 6.7 months, and median age at relapse was 66 years (ALK-positive ALCL, 39 years). Median overall survival (OS) and median progression-free survival (PFS) after relapse or progression (second PFS) were 5.5 and 3.1 months, respectively, and were only marginally better in patients who received chemotherapy at relapse (n = 89 [58%]; 6.5 and 3.7 months, respectively). Patients with good performance status (PS) of 0 or 1 (n = 47) at relapse who received chemotherapy had a more favorable OS (P < .001; median OS, 13.7 months) and PFS (P = .006; median second PFS, 5.0 months), which remained significant in multivariate analysis (OS: hazard ratio [HR], 2.09; P = .002; second PFS: HR, 1.66; P = .030).ConclusionMost patients with relapsed or refractory PTCL have poor outcomes with short survival. Select patients with good PS have more favorable outcomes with standard chemotherapy. (c) 2013 by American Society of Clinical Oncology