Retrospective analysis of prognostic factors for angioimmunoblastic T-cell lymphoma: a multicenter cooperative study in Japan

Author:

Tokunaga Takashi1,Shimada Kazuyuki1,Yamamoto Kazuhito2,Chihara Dai2,Ichihashi Takuji3,Oshima Rika4,Tanimoto Mitsune5,Iwasaki Toshihiro6,Isoda Atsushi7,Sakai Akira8,Kobayashi Hikaru9,Kitamura Kunio10,Matsue Kosei11,Taniwaki Masafumi12,Tamashima Sadahiro13,Saburi Yoshio14,Masunari Taro15,Naoe Tomoki1,Nakamura Shigeo16,Kinoshita Tomohiro2

Affiliation:

1. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan;

2. Aichi Cancer Center, Nagoya, Japan;

3. Okazaki City Hospital, Okazaki, Japan;

4. Yokohama City University Medical Center, Yokohama, Japan;

5. Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan;

6. Toyohashi Municipal Hospital, Toyohashi, Japan;

7. Nishigunma National Hospital, Shibukawa, Japan;

8. Hiroshima University, Hiroshima, Japan;

9. Nagano Red Cross Hospital, Nagano, Japan;

10. Ichinomiya Municipal Hospital, Ichinomiya, Japan;

11. Kameda General Hospital, Kamogawa, Japan;

12. Kyoto Prefectural University of Medicine, Kyoto, Japan;

13. Seirei Hamamatsu General Hospital, Hamamatsu, Japan;

14. Oita Prefectural Hospital, Oita, Japan;

15. Chugoku Central Hospital, Fukuyama, Japan; and

16. Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan

Abstract

Abstract Angioimmunoblastic T-cell lymphoma (AITL) is a major type of peripheral T-cell lymphoma (PTCL). To elucidate the clinicopathologic characteristics and prognosis of AITL in Japan, we retrospectively analyzed 207 patients with AITL. The median patient age was 67 years (range, 34-91 years), with 73% of patients older than 60 years. With a median follow-up of 42 months in surviving patients, 3-year overall survival (OS) was 54% and progression-free survival (PFS) was 38%. The International Prognostic Index (IPI) and the prognostic index for PTCL, not otherwise specified (PIT) were predictive for OS in this analysis. Multivariate analysis found that age older than 60 years, elevated white blood cell (WBC) and IgA levels, the presence of anemia and thrombocytopenia, and extranodal involvement at > 1 site were significant prognostic factors for OS, and IgA, anemia, and mediastinal lymphadenopathy were significant prognostic factors for PFS. A novel prognostic model consisting of the prognostic factors for OS was successfully constructed. In conclusion, IPI and PIT were still useful for prognostication of AITL, and other factors, including those not used in IPI, such as IgA, anemia, WBC count, thrombocytopenia, and mediastinal lymphadenopathy, also significantly affected prognosis. Future investigations for IgA as a unique prognostic factor are warranted.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

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