Journal
BLOOD
Volume 138, Issue 3, Pages 213-220Publisher
AMER SOC HEMATOLOGY
DOI: 10.1182/blood.2020010387
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Funding
- Fondazione Cassa di Risparmio di Modena
- Associazione Angela Serra per la Ricerca sul Cancro
- Fondazione Italiana Linfomi
- Allos Therapeutics
- Spectrum Pharmaceuticals
- Associazione Italiana per la Ricerca sul Cancro
- National Institutes of Health, National Cancer Institute [CCSG P30 CA008748]
- Italian Association for Cancer Research [10007, 20198]
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AITL is a subtype of PTCL with distinct features and poor prognosis. A new prognostic score (AITL score) combining age, ECOG performance status, CRP, and beta 2 microglobulin was developed. Disease progression within 24 months (POD24) was a powerful prognostic factor.
Angioimmunoblastic T-cell lymphoma (AITL) is a unique subtype of peripheral T-cell lymphoma (PTCL) with distinct clinicopathologic features and poor prognosis. We performed a subset analysis of 282 patients with AITL enrolled between 2006 and 2018 in the international prospective T-cell Project (NCT01142674). The primary and secondary end points were 5-year overall survival (OS) and progression-free survival (PFS), respectively. We analyzed the prognostic impact of clinical covariates and progression of disease within 24 months (POD24) and developed a novel prognostic score. The median age was 64 years, and 90% of patients had advanced-stage disease. Eighty-one percent received anthracycline-based regimens, and 13% underwent consolidative autologous stem cell transplant (ASCT) in first complete remission (CR1). Five-year OS and PFS estimates were 44% and 32%, respectively, with improved outcomes for patients who underwent ASCT in CR1. In multivariate analysis, age >= 60 years, Eastern Cooperative Oncology Group performance status >2, elevated C-reactive protein, and elevated beta 2 microglobulin were associated with inferior outcomes. A novel prognostic score (AITL score) combining these factors defined low-, intermediate-, and high-risk subgroups with 5-year OS estimates of 63%, 54%, and 21%, respectively, with greater discriminant power than established prognostic indices. Finally, POD24 was a powerful prognostic factor with 5-year OS of 63% for patients without POD24 compared with only 6% for patients with POD24 (P < .0001). These data will require validation in a prospective cohort of homogeneously treated patients. Optimal treatment of AITL continues to be an unmet need, and novel therapeutic approaches are required.
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