Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: Results from the PETAL consortium Journal Article
| Authors: | Han, J. X.; Koh, M. J.; Boussi, L.; Sorial, M.; McCabe, S. M.; Peng, L.; Singh, S.; Eche-Ugwu, I. J.; Gabler, J.; Fernandez Turizo, M. J.; MacVicar, C. T.; Garg, A.; Disciullo, A.; Chopra, K.; Lenart, A.; Nwodo, E.; Barnes, J.; Koh, M. J.; Miranda, E.; Chiattone, C.; Stuver, R.; Horwitz, S. M.; Merrill, M.; Jacobsen, E.; Manni, M.; Civallero, M.; Skrypets, T.; Lymboussaki, A.; Federico, M.; Kim, Y.; Kim, J. S.; Cho, J. Y.; Eipe, T.; Shet, T.; Sridhar, E.; Shetty, A.; Saha, S.; Jain, H.; Sengar, M.; Van Der Weyden, C.; Prince, H. M.; Hamouche, R.; Murdashvili, T.; Foss, F.; Gentilini, M.; Casadei, B.; Zinzani, P. L.; Okatani, T.; Yoshida, N.; Yoon, S. E.; Kim, W. S.; Panchoo, G.; Mohamed, Z.; Verburgh, E.; Alturas, J. C.; Al-Mansour, M.; Ford, J.; Cabrera, M. E.; Ku, A.; Bhagat, G.; Ma, H.; Sawas, A.; Kariya, K. M.; Iwasaki, M.; Bhanushali, F.; O’Connor, O. A.; Marchi, E.; Shen, C.; Shah, D.; Jain, S. |
| Article Title: | Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: Results from the PETAL consortium |
| Abstract: | Variances in global access to drugs and treatment practices make it challenging to understand the benefit of contemporary therapies in patients with relapsed and refractory (R/R) mature T-cell and natural killer–cell lymphomas (MTCL and MNKCL). We conducted an international retrospective cohort study of 925 patients with R/R MTCL and MNKCL. In peripheral T-cell lymphoma–not otherwise specified and anaplastic lymphoma kinase–negative anaplastic large cell lymphoma (ALK– ALCL), patients with relapsed lymphoma demonstrated a superior median overall survival (OS) relative to refractory from the time of second-line treatment. We identified several independent predictors of OS for R/R lymphoma including age >60 years, primary refractory disease, histological subtype other than angioimmunoblastic T-cell lymphoma (AITL), extranodal sites >1, Ki67 ≥40%, and absolute lymphocyte count less than the lower limit of normal. A multivariable model incorporating these formed the basis for a prognostic index for R/R TCL, in which patients are stratified into low-risk (0-1 risk factor), intermediate-risk (2-3 risk factors), or high-risk (≥4 risk factors) groups, which were associated with 3-year OS of 57.14%, 23.3%, and 7%, respectively. Patients received either a "novel" single agent (SA; 35%) or cytotoxic chemotherapy (CC; 60%) for their second-line treatment. Higher progression-free survival was observed with SA over CC for the entire cohort with a higher 3-year OS in AITL and ALK– ALCL. Among the SA, small-molecule inhibitors demonstrated OS advantage relative to CC in AITL. Our results highlight continued efficacy of novel drugs globally and the potential of a new prediction model in informing heterogeneous prognosis within the R/R population of MTCL and MNKCL. © 2024 by The American Society of Hematology. All other rights reserved. |
| Keywords: | adult; aged; survival analysis; major clinical study; overall survival; cancer recurrence; doxorubicin; area under the curve; cytarabine; methotrexate; outcome assessment; follow up; ki 67 antigen; progression free survival; bortezomib; etoposide; cohort analysis; dexamethasone; retrospective study; risk factor; histology; t cell lymphoma; fluorescence in situ hybridization; training; probability; tipifarnib; allogeneic hematopoietic stem cell transplantation; lactate dehydrogenase; kaplan meier method; anthracycline; romidepsin; cyclosporine; nk t cell lymphoma; recurrence free survival; anaplastic large cell lymphoma; diffuse large b cell lymphoma; refractory cancer; cancer prognosis; ruxolitinib; alisertib; human; male; female; article; duvelisib; cyclophosphamide plus doxorubicin plus etoposide plus prednisolone plus rituximab plus vincristine; cyclophosphamide plus doxorubicin plus etoposide plus prednisolone plus vincristine; cerdulatinib; alk-negative anaplastic large cell lymphoma |
| Journal Title: | Blood Advances |
| Volume: | 9 |
| Issue: | 3 |
| ISSN: | 2473-9529 |
| Publisher: | American Society of Hematology |
| Date Published: | 2025-02-11 |
| Start Page: | 583 |
| End Page: | 602 |
| Language: | English |
| DOI: | 10.1182/bloodadvances.2024014674 |
| PUBMED: | 39481087 |
| PROVIDER: | scopus |
| PMCID: | PMC11821408 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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