The Clinical Features And Prognostic Factors Of T Cell Lymphoma And Its Significance

Objective:To explore the clinical features of T-cell lymphoma (TCL) in Chinese patients, and analyze the prognostic significance of serum lactate dehydrogenase (LDH), extra nodal involvement stage, IPI score with TCL cases.Method:One hundred and sixty-eight patients who were diagnosed as TCL by pathology from January2006to December2011in First Affiliated Hospital, College of Medicine, Zhejiang University were enrolled and analyzed retrospectively. All of the cases were determined according to WHO2001classification, and followed up by telephone. Collected the level of serum LDH and(32-MG, and the score of extra nodal involvement stage and IPI. The associations between these parameters and survival time were analyzed.Result:1) Firstly, among the168TCL patients, the average age was46, the ratio of male to female was1.90:1. Twenty-eight patients were older than60, accounting for16.7%. Twenty-eight cases (16.7%) are nasal NK/T cell lymphoma,18cases (10.7%) are blastic NK-cell Lymphoma,6cases (3.6%) are enteropathy type T cell lymphoma,7cases (4.2%) subcutaneous panniculitis-like T cell Lymphoma,12cases (7.2%) are angioimmunoblastic T-cell lymphoma,2cases(1.2%)are anaplastic large cell lymphoma,95cases (56.5%) peripheral T-cell lymphoma unspecified. Forty-nine cases (45.5%) were firstly diagnosed from lymph node involvement, and twenty cases (21.1%) were firstly diagnosed from bone marrow involvement at the time of presentation in95cases of peripheral T-cell lymphoma unspecified. One hundred-five patients had B symptoms, accounting for62.5%.2) Forty patients received the combined chemo-radiotherapy,114patients received the chemotherapy only,6patients received the supportive treatment only and the other6were treated with autologous stem cell transplantation. The median survival time is22.4months. Among168followed-up cases during the median32.6-month follow-up,124(73.8%) died of TCL; and64cases (38.1%) passed away in the first year after diagnosis.3) In this study, the over all survival time was significantly higher in elevated LDH group than in normal group (P<.05).4) The survival time with the extra nodal involvement stage (ECOG)>2was lower than those patients (ECOG)>2.5) The survival time with the international prognostic index (IPI)0-2was lower than those patients (IPI)3-5.Conclusions:1) In TCL cases, the elevated LDH level could be a poor prognostic factor and be associated with clinical staging.2) The score of the extra nodal involvement stage level might be associated with clinical staging and survival. The survival time with the extra nodal involvement stage(ECOG)>2was lower than those patients (ECOG)0-1. 3) The score of the international prognostic index (IPI) might be associated with clinical staging and survival. The survival time with the international prognostic index (IPI)0-2was longer than those patients (IPI)3-5.