Long-term outcome of peripheral T-cell lymphomas: Ten-year follow-up of the International Prospective T-cell Project.

in British journal of haematology by M Civallero, J G Schroers-Martin, S Horwitz, M Manni, Y Stepanishyna, M E Cabrera, J Vose, M Spina, F Hitz, A Nagler, S Montoto, C Chiattone, T Skrypets, M A Perez Saenz, G Priolo, S Luminari, A Lymboussaki, A Pavlovsky, D Marino, M Liberati, J Trotman, D Mannina, M Federico, R Advani

TLDR

  • The study analyzed the long-term outcomes of patients with Peripheral T-cell lymphomas (PTCLs) and found that most deaths occurred within 5 years, and patients with low-risk International Prognostic Index and Prognostic Index for T-cell lymphoma scores had improved survival.

Abstract

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of haematological cancers with generally poor clinical outcomes. However, a subset of patients experience durable disease control, and little is known regarding long-term outcomes. The International T-cell Lymphoma Project (ITCLP) is the largest prospectively collected cohort of patients with PTCLs, providing insight into clinical outcomes at academic medical centres globally. We performed a long-term outcome analysis on patients from the ITCLP with available 10-year follow-up data (n = 735). The overall response rate to first-line therapy was 68%, while 5- and 10-year overall survival estimates were 49% and 40% respectively. Most deaths occurred prior to 5 years, and for patients alive at 5 years, the chance of surviving to 10 years was 84%. However, lymphoma remained the leading cause of death in the 5- to 10-year period (67%). Low-risk International Prognostic Index and Prognostic Index for T-cell lymphoma scores both identified patients with improved survival, while in multivariate analysis, age >60 years and Eastern Cooperative Oncology Group performance status 2-4 were associated with inferior outcomes. The favourable survival seen in patients achieving durable initial disease control emphasizes the unmet need for optimal front-line therapeutic approaches in PTCLs.

Overview

  • The study analyzed the long-term outcomes of patients with Peripheral T-cell lymphomas (PTCLs) from the International T-cell Lymphoma Project (ITCLP), the largest prospectively collected cohort of patients with PTCLs.
  • The study aimed to investigate the overall response rate to first-line therapy, overall survival estimates, and the impact of various clinical and demographic variables on outcomes.
  • The primary objective was to identify the factors associated with improved or inferior survival in patients with PTCLs and to explore the unmet need for optimal front-line therapeutic approaches in PTCLs.

Comparative Analysis & Findings

  • The study found that the overall response rate to first-line therapy was 68%, with 5- and 10-year overall survival estimates of 49% and 40%, respectively.
  • Most deaths occurred prior to 5 years, and for patients alive at 5 years, the chance of surviving to 10 years was 84%.
  • Lymphoma remained the leading cause of death in the 5- to 10-year period (67%), and patients with low-risk International Prognostic Index and Prognostic Index for T-cell lymphoma scores had improved survival.

Implications and Future Directions

  • The study highlights the need for optimal front-line therapeutic approaches in PTCLs, which could improve overall survival and reduce the risk of lymphoma-related deaths.
  • Future research should focus on identifying biomarkers and therapies that can predict durable disease control and optimize treatment outcomes for patients with PTCLs.
  • Prospective studies with long-term follow-up data can provide valuable insights into the natural history of PTCLs and inform the development of novel therapeutic strategies.
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