Analysis Of Therapeutic Effect And Prognostic Factors Of The Peripheral T Cell Lymphoma

ObjectiveTo investigate the clinical therapeutic effect and prognostic factors of peripheral T cell lymphoma(PTCL).MethodThe data of 61 patients with PTCL admitted into the Hematology Department of the Second Affiliated Hospital of Soochow University from October 2009 to December 2017 were analysed.The data included general features(age,gender,Ann Arbor staging,B symptoms,ECOG scores,IPI index,PIT index),pathological type,invasion of bone marrow,laboratory examination(blood routine,LDH,β2-microglobulin,ki-67 percentage,etc.),and short-term efficacy,long-term survival(time to progression,survival time and status).SPSS 17.0 statistical software was used for data analysis.p< 0.05 has statistical significance.Results1.Among the 61 PTCL patients,the ratio of male to female was about 2: 1,aged from 15 to 86 and the median age was 61.Twenty-seven cases(44%)are peripheral T cell lymphoma not otherwise specified(PTCL-NOS).Twenty-one cases(34%)are extranodal NK/T-cell lymphoma,nasal type(ENKTCL,nasal)(one case is primary cutaneous type NK/T-cell lymphoma).The others included six cases(10%)of angioimmunoblastic T-cell lymphoma(AITL),three case(5%)of anaplastic large cell lymphoma(ALK-positive)(AKL+ALCL),two cases(3%)of Enteropathy-associated T-cell lymphoma(EATL),one case(2%)of Subcutaneous panniculitis-like T-cell lymphoma(SPTCL)and the other one(2%)is Mycosis fungoides(MF).2.A total of 36 patients achieved complete remission(CR)and partial remission(PR),and the initial therapeutic overall response rate(ORR)was 59%.Ann Arbor staging,B symptoms,ECOG scores,IPI index,β2-microglobulin,invasion of bone marrow and abnormal blood routine were associated with the efficacy of initial treatment.3.To the date of follow-up,twenty-six patients(43%)died and thirty-five(54%)survived.The median survival time was 15 months,and 1-year,3-year,5-year cumulative survival rates were 70%,53% and 48%.The progression-free surviva of 1-year,3-year,5-year were 58%、44%、37%.The 5-year overall survival rates and 5-year progression-free survival of PTCL-NOS and NK/TCL were 34%,26% and 73%,61%,respectively.4.Kaplan-meier univariate analysis shows that Ann Arbor staging(III-IV staging,p=0.006),B symptoms(p﹤0.001),ECOG ≥2 scores(p﹤0.001),and higher IPI index(p﹤0.001),PIT index(p=0.005)were associated with significantly shorter survival time.The increased onset β2-microglobulin(p﹤0.001),elevated LDH(p=0.047)bone marrow involvement(p﹤0.001),efficacy of remission(CR+PR,p﹤0.001)and pathological type(p=0.017)were associated with survival rates.Cox multivariate analysis verified that B symptoms,β2-microglobulin,LDH and efficacy were independent factors for predicting outcomes(p﹤0.05).Conclusion1.The Ann Arbor staging,B symptoms,ECOG score and IPI index,PIT index,β2-microglobulin and LDH,bone marrow involvement,pathological type are related to overall survival rate of PTCL.2.B symptoms,β2-microglobulin,LDH and efficacy of remission are the independent prognostic factors.3.Achieving remission after initial treatment is expected to improve the survival rate for PTCL patients.