Blood Journal
Leading the way in experimental and clinical research in hematology

Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German High-Grade Non-Hodgkin Lymphoma Study Group

  1. Norbert Schmitz1,
  2. Lorenz Trümper2,
  3. Marita Ziepert3,
  4. Maike Nickelsen1,
  5. Anthony D. Ho4,
  6. Bernd Metzner5,
  7. Norma Peter6,
  8. Markus Loeffler3,
  9. Andreas Rosenwald7, and
  10. Michael Pfreundschuh8
  1. 1Department of Hematology, Oncology and Stem Cell Transplantation, Asklepios Hospital St Georg, Hamburg, Germany;
  2. 2Department of Hematology and Oncology, University of Göttingen, Göttingen, Germany;
  3. 3Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany;
  4. 4Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany;
  5. 5Department of Hematology and Oncology, Klinikum Oldenburg, Oldenburg, Germany;
  6. 6Department of Hematology and Oncology, Carl-Thiem Klinikum, Cottbus, Germany;
  7. 7Institute of Pathology, University of Würzburg, Würzburg, Germany; and
  8. 8Department of Internal Medicine I, Saarland University, Homburg/Saar, Germany

Abstract

To evaluate outcome and prognosis of patients with T-cell lymphoma we analyzed 343 patients treated within trials of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Two hundred eighty-nine patients belonged to 1 of the 4 major T-cell lymphoma subtypes: anaplastic large cell lymphoma (ALCL), anaplastic large cell lymphoma kinase (ALK)–positive (n = 78); ALCL, ALK-negative (n = 113); peripheral T-cell lymphoma, unspecified (PTCLU; n = 70); and angioimmunoblastic T-cell lymphoma (AITL; n = 28). Treatment consisted of 6-8 courses of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone/prednisolone) or etoposide plus (CHOEP). Three-year event-free survival (EFS) and overall survival were 75.8% and 89.8% (ALK-positive ALCL), 50.0% and 67.5% (AITL), 45.7% and 62.1% (ALK-negative ALCL), and 41.1% and 53.9% (PTCLU), respectively. The International Prognostic Index (IPI) was effective in defining risk groups with significantly different outcomes. For patients, ≤ 60 years with lactate dehydrogenase ≤ upper normal value (UNV), etoposide improved improved 3-year EFS: 75.4% versus 51.0%, P = .003. In patients > 60 years 6 courses of CHOP administered every 3 weeks remains the standard therapy. Patients with ALK-negative ALCL, PTCLU, or AITL presenting with IPI > 1 have a poor prognosis and should be considered candidates for novel treatment strategies.

  • Submitted February 22, 2010.
  • Accepted June 23, 2010.
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