Analysis Of Clinical Cases Of 71 Patients With T Cell Lymphoma

Objective: To investigate the clinical characteristics,treatment strategy and efficacy,and prognosis of patients with T cell lymphoma.Methods: We reviewed clinical data and follow-up information of 71 T cell lymphoma patients newly diagnosed in the Second Affiliated Hospital of Dalian Medical University from January1,2011 to December31,2015.Clinical data included general information(gender,age,Ann Arbor stage,ECOG score,IPI score),pathological types,the first clinical manifestations,involved sites,laboratory findings(a complete blood count,serum LDH,serum ?2-MG,markers for viral hepatitis,Ki-67index),treatment regimens,the primary outcome,long-term survival(progression free survival,PFS;overall survival,OS).Statistical analysis was conducted with SPSS 17.0.A P value of < 0.05 was considered statistically significant.Results:1.Common features: the male-to-female ratio was nearly 3:1,and the median age for the patients was 59 years.At diagnosis,70.42% of patients had stage III-IV,78.87% had IPI scores 2-5.2.Pathological types : PTCL-NOS(30 cases,42.25%),ENKTL,nasal type(10cases,14.08%),AITL(10 cases,14.08%),ALCL(8cases,11.27%),T-ALL/LBL(7cases,9.87%),and CTCL(6cases,8.45%).3.The first clinical manifestations: surface mass(39cases),skin lesions(11cases),nasal obstruction(10cases),abdominal pain(6cases),B-symptoms(38cases).4.Involved sites:Only nodal disease was present in 36.62%,nodal andextranodal disease in 36.62%,and extranodal disease only was present in 26.76% of the patients.The common extranodal sites included the spleen(9cases,12.68%),the nasal cavity(8cases,11.27%),the intestines(8cases,11.27%),the skin(6cases,8.45%)and the bone marrow(6cases,8.45%).5.Laboratory findings:WBC 1.99-34.4×10~9/L,HGB 47.2-174g/L,PLT27-508×10~9/L.elevated serum LDH(50.70%),elevated serum ?2-microglobulin(49.02%).6 patients had bone arrow involvement and 5 patients progressed to lymphoma cell leukemia.6.Treatment and outcome:Among 39 patients,30 patients was treated with the CHOP-like regimens,3 patients with the Hyper-CVAD regimens,3 patients with regimens based on ATO,3 patients with the regimens based on bortezomib.Median follow-up time was 12 months.20 cases obtained CR/PR and 19 patients abtained SD/PD.By the end of the study,18 patients progressed or relapsed and 13 patients was died.1-y PFS and OS was 42%,63%;5-y PFS and OS were 40%,47%.7.Prognosis:Univariate survival analysis shows that the primary outcome is predictive of both 1-y PFS(P=0.00)and OS(P=0.01),and treatment regimens is predictive of 1-y OS(P=0.04).Multivariate survival analysis shows that the primary outcome is predictive of both 1-y PFS(P=0.00)and 1-y OS(P=0.01);however,the treatment regimens is not predictive of 1-y OS(P=0.58).Conclusions:T cell lymphoma had diverse clinical manifestations.The majority of patients were male.The first clinical manifestations were related with the involved sites.The majority presented with advanced stage disease and intermediate/high risk.Most of the patients were treated with CHOP-like regimens,except for ENK/TL,nasal type patients who were treated mainly with radiotherapy,efforts to develop novel agents or novel agent combinations are still needed.Hematopoietic cell transplantation(HCT)can be a sequential treatment approach for patients in complete response.The primary outcome was predictive of 1-y PFS and OS;the better primary outcome,the better prognosis.