The CNS relapse in T-cell lymphoma index predicts CNS relapse in patients with T- and NK-cell lymphomas Journal Article
| Authors: | Bhansali, R. S.; Ellin, F.; Relander, T.; Cao, M.; Li, W.; Long, Q.; Ganesan, N.; Stuver, R.; Horwitz, S. M.; Wudhikarn, K.; Hwang, S. R.; Bennani, N. N.; Chavez, J.; Sokol, L.; Saeed, H.; Duan, F.; Porcu, P.; Pullarkat, P.; Mehta-Shah, N.; Zain, J. M.; Ruiz, M.; Brammer, J. E.; Prakash, R.; Iyer, S. P.; Olszewski, A. J.; Major, A.; Riedell, P. A.; Smith, S. M.; Goldin, C.; Haverkos, B.; Hu, B.; Zhuang, T. Z.; Allen, P. B.; Toama, W.; Janakiram, M.; Brooks, T. R.; Jagadeesh, D.; Hariharan, N.; Goodman, A. M.; Hartman, G.; Ghione, P.; Fayyaz, F.; Rhodes, J. M.; Chong, E. A.; Gerson, J. N.; Landsburg, D. J.; Nasta, S. D.; Schuster, S. J.; Svoboda, J.; Jerkeman, M.; Barta, S. K. |
| Article Title: | The CNS relapse in T-cell lymphoma index predicts CNS relapse in patients with T- and NK-cell lymphomas |
| Abstract: | Little is known about risk factors for central nervous system (CNS) relapse in mature T-cell and natural killer cell neoplasms (MTNKNs). We aimed to describe the clinical epidemiology of CNS relapse in patients with MTNKN and developed the CNS relapse In T-cell lymphoma Index (CITI) to predict patients at the highest risk of CNS relapse. We reviewed data from 135 patients with MTNKN and CNS relapse from 19 North American institutions. After exclusion of leukemic and most cutaneous forms of MTNKNs, patients were pooled with non-CNS relapse control patients from a single institution to create a CNS relapse–enriched training set. Using a complete case analysis (n = 182), including 91 with CNS relapse, we applied a least absolute shrinkage and selection operator Cox regression model to select weighted clinicopathologic variables for the CITI score, which we validated in an external cohort from the Swedish Lymphoma Registry (n = 566). CNS relapse was most frequently observed in patients with peripheral T-cell lymphoma, not otherwise specified (25%). Median time to CNS relapse and median overall survival after CNS relapse were 8.0 and 4.7 months, respectively. We calculated unique CITI risk scores for individual training set patients and stratified them into risk terciles. Validation set patients with low-risk (n = 158) and high-risk (n = 188) CITI scores had a 10-year cumulative risk of CNS relapse of 2.2% and 13.4%, respectively (hazard ratio, 5.24; 95% confidence interval, 1.50-18.26; P = .018). We developed an open-access web-based CITI calculator (https://redcap.link/citicalc) to provide an easy tool for clinical practice. The CITI score is a validated model to predict patients with MTNKN at the highest risk of developing CNS relapse. © 2024 by The American Society of Hematology. |
| Keywords: | adolescent; adult; controlled study; human tissue; treatment response; aged; survival rate; major clinical study; janus kinase 2; cytarabine; methotrexate; flow cytometry; progression free survival; anemia; etoposide; thrombocytopenia; cohort analysis; relapse; risk factor; acute lymphoblastic leukemia; t cell lymphoma; hematologic malignancy; fluorescence in situ hybridization; multicenter study; panniculitis; graft versus host reaction; lactate dehydrogenase; mycosis fungoides; azacitidine; platelet count; kidney transplantation; recurrence free survival; non small cell lung cancer; anaplastic lymphoma kinase; lymphoblastoma; acute myeloid leukemia; human; male; female; article; large granular lymphocyte leukemia; subcutaneous t cell lymphoma; cutaneous gamma delta t cell lymphoma |
| Journal Title: | Blood Advances |
| Volume: | 8 |
| Issue: | 13 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2024-07-09 |
| Start Page: | 3507 |
| End Page: | 3518 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2024012800 |
| PUBMED: | 38739715 |
| PROVIDER: | scopus |
| PMCID: | PMC11261035 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. -- Source: Scopus |
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