Advertisement

Annals of Hematology

, Volume 94, Issue 2, pp 239–247 | Cite as

Analysis of prognostic factors and comparison of prognostic scores in peripheral T cell lymphoma, not otherwise specified: a single-institution study of 105 Chinese patients

  • Pengpeng Xu
  • Dong Yu
  • Li Wang
  • Yang Shen
  • Zhixiang Shen
  • Weili ZhaoEmail author
Original Article

Abstract

Peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) is a heterogeneous subtype of non-Hodgkin’s lymphoma. This study aims to better define the prognostic factors and compare the predictive value of the prognostic scores in Chinese patients with PTCL-NOS. One hundred and five patients diagnosed as PTCL-NOS from our institution were retrospectively studied and grouped according to four previously described prognostic scores [International Prognostic Index (IPI), Prognostic Index for PTCL-NOS (PIT), modified PIT (m-PIT), and International PTCL Project (IPTCLP)]. In addition to clinical parameters, peripheral lymphopenia and thrombocytopenia, serum Epstein-Barr virus positivity, and tumor Ki-67 were significantly associated with poor disease outcome. Multivariate analysis revealed that age >60 years, poor performance status, elevated lactic dehydrogenase, and bone marrow involvement were independent adverse variables for survival. All prognostic scores were successful for survival estimation. Risk subgroups in IPI and PIT could be further discriminated by platelet count (IPTCLP factor) and Ki-67 (m-PIT factor), respectively. Together, patient- and tumor-specific characteristics may be incorporated in risk stratification of PTCL-NOS patients. The prognostic scores could be mutually active to improve their predictive value of disease outcome.

Keywords

Peripheral T cell lymphoma, not otherwise specified Prognosis Prognostic scores 

Notes

Acknowledgments

This work was supported by the National Natural Science Foundation of China (81172254, 81201862, 81201863, and 81325003), the Shanghai Commission of Science and Technology (11JC1407300), the Program of Shanghai Subject Chief Scientist (13XD1402700), and the Excellent Young Teacher of Ruijin Hospital (80000000000003).

Conflict of interest

None of the authors declare conflicts of interest.

References

  1. 1.
    Vose J, Armitage J, Weisenburger D (2008) International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clinical Oncol 26(25):4124–4130. doi: 10.1200/JCO.2008.16.4558 CrossRefGoogle Scholar
  2. 2.
    The International Non-Hodgkin’s Lymphoma Prognostic Factors Project (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med 329(14):987–994. doi: 10.1056/NEJM199309303291402 CrossRefGoogle Scholar
  3. 3.
    Weisenburger DD, Savage KJ, Harris NL, Gascoyne RD, Jaffe ES, MacLennan KA, Rudiger T, Pileri S, Nakamura S, Nathwani B, Campo E, Berger F, Coiffier B, Kim WS, Holte H, Federico M, Au WY, Tobinai K, Armitage JO, Vose JM (2011) Peripheral T-cell lymphoma, not otherwise specified: a report of 340 cases from the International Peripheral T-cell Lymphoma Project. Blood 117(12):3402–3408. doi: 10.1182/blood-2010-09-310342 PubMedCrossRefGoogle Scholar
  4. 4.
    Gallamini A, Stelitano C, Calvi R, Bellei M, Mattei D, Vitolo U, Morabito F, Martelli M, Brusamolino E, Iannitto E, Zaja F, Cortelazzo S, Rigacci L, Devizzi L, Todeschini G, Santini G, Brugiatelli M, Federico M (2004) Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood 103(7):2474–2479. doi: 10.1182/blood-2003-09-3080 PubMedCrossRefGoogle Scholar
  5. 5.
    Vose JM (2005) International Peripheral T-Cell Lymphoma (PTCL) clinical and pathologic review project: poor outcome by prognostic indices and lack of efficacy with anthracyclines. Blood 106(811a)Google Scholar
  6. 6.
    Went P, Agostinelli C, Gallamini A, Piccaluga PP, Ascani S, Sabattini E, Bacci F, Falini B, Motta T, Paulli M, Artusi T, Piccioli M, Zinzani PL, Pileri SA (2006) Marker expression in peripheral T-cell lymphoma: a proposed clinical-pathologic prognostic score. J Clin Oncol 24(16):2472–2479. doi: 10.1200/JCO.2005.03.6327 PubMedCrossRefGoogle Scholar
  7. 7.
    Swerdlow SH, International Agency for Research on Cancer, World Health Organization (2008) WHO classification of tumours of haematopoietic and lymphoid tissues. World Health Organization classification of tumours, 4th edn. International Agency for Research on Cancer, LyonGoogle Scholar
  8. 8.
    Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17(4):1244PubMedGoogle Scholar
  9. 9.
    Nikoskelainen J, Neel EU, Stevens DA (1979) Epstein-Barr virus-specific serum immunoglobulin A as an acute-phase antibody in infectious mononucleosis. J Clin Microbiol 10(1):75–79PubMedCentralPubMedGoogle Scholar
  10. 10.
    Okano M (1998) Epstein-Barr virus infection and its role in the expanding spectrum of human diseases. Acta Paediatr 87(1):11–18PubMedCrossRefGoogle Scholar
  11. 11.
    Okano M, Thiele GM, Davis JR, Grierson HL, Purtilo DT (1988) Epstein-Barr virus and human diseases: recent advances in diagnosis. Clin Microbiol Rev 1(3):300–312PubMedCentralPubMedGoogle Scholar
  12. 12.
    Xu PP, Wang Y, Shen Y, Wang L, Shen ZX, Zhao WL (2012) Prognostic factors of Chinese patients with T/NK-cell lymphoma: a single institution study of 170 patients. Med Oncol 29(3):2176–2182. doi: 10.1007/s12032-011-0011-0 PubMedCrossRefGoogle Scholar
  13. 13.
    Imashuku S (2002) Clinical features and treatment strategies of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis. Crit Rev Oncol Hematol 44(3):259–272PubMedCrossRefGoogle Scholar
  14. 14.
    Yang QP, Zhang WY, Yu JB, Zhao S, Xu H, Wang WY, Bi CF, Zuo Z, Wang XQ, Huang J, Dai L, Liu WP (2011) Subtype distribution of lymphomas in Southwest China: analysis of 6,382 cases using WHO classification in a single institution. Diagn Pathol 6:77. doi: 10.1186/1746-1596-6-77 PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Au WY, Ma SY, Chim CS, Choy C, Loong F, Lie AK, Lam CC, Leung AY, Tse E, Yau CC, Liang R, Kwong YL (2005) Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years. Ann Oncol 16(2):206–214. doi: 10.1093/annonc/mdi037 PubMedCrossRefGoogle Scholar
  16. 16.
    Lee Y, Uhm JE, Lee HY, Park MJ, Kim H, Oh SJ, Jang JH, Kim K, Jung CW, Ahn YC, Park K, Ko YH, Kim WS (2009) Clinical features and prognostic factors of patients with “peripheral T cell lymphoma, unspecified”. Ann Hematol 88(2):111–119. doi: 10.1007/s00277-008-0544-2 PubMedCrossRefGoogle Scholar
  17. 17.
    Gutierrez-Garcia G, Garcia-Herrera A, Cardesa T, Martinez A, Villamor N, Ghita G, Martinez-Trillos A, Colomo L, Setoain X, Rodriguez S, Gine E, Campo E, Lopez-Guillermo A (2011) Comparison of four prognostic scores in peripheral T-cell lymphoma. Ann Oncol 22(2):397–404. doi: 10.1093/annonc/mdq359 PubMedCrossRefGoogle Scholar
  18. 18.
    Torimoto Y, Sato K, Ikuta K, Hayashi T, Hirayama Y, Inamura J, Kobayashi H, Kobayashi R, Koda K, Kurosawa M, Mori A, Ota S, Sakai H, Shigematsu A, Shindo M, Shinzaki H, Takahashi F, Takimoto R, Tanaka J, Yamamoto S, Kohgo Y, Fukuhara T (2013) A retrospective clinical analysis of Japanese patients with peripheral T-cell lymphoma not otherwise specified: Hokkaido Hematology Study Group. Int J Hematol 98(2):171–178. doi: 10.1007/s12185-013-1383-z PubMedCrossRefGoogle Scholar
  19. 19.
    Lin HN, Liu CY, Pai JT, Chang FP, Yang CF, Yu YB, Hsiao LT, Chiou TJ, Liu JH, Gau JP, Tzeng CH, Chen PM, Hong YC (2012) How to predict the outcome in mature T and NK cell lymphoma by currently used prognostic models? Blood Cancer J 2:e93. doi: 10.1038/bcj.2012.23 PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Ray-Coquard I, Cropet C, Van Glabbeke M, Sebban C, Le Cesne A, Judson I, Tredan O, Verweij J, Biron P, Labidi I, Guastalla JP, Bachelot T, Perol D, Chabaud S, Hogendoorn PC, Cassier P, Dufresne A, Blay JY (2009) Lymphopenia as a prognostic factor for overall survival in advanced carcinomas, sarcomas, and lymphomas. Cancer Res 69(13):5383–5391. doi: 10.1158/0008-5472.CAN-08-3845 PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Mitrovic Z, Perry AM, Suzumiya J, Armitage JO, Au WY, Coiffier B, Holte H, Jaffe ES, Monserrat E, Rajan SK, Savage KJ, Tobinai K, Vose JM, Weisenburger DD (2012) The prognostic significance of lymphopenia in peripheral T-cell and natural killer/T-cell lymphomas: a study of 826 cases from the International Peripheral T-cell Lymphoma Project. Am J Hematol 87(8):790–794. doi: 10.1002/ajh.23205 PubMedCrossRefGoogle Scholar
  22. 22.
    Monfardini S, Sorio R, Cavalli F, Cerny TH, Van Glabbeke M, Kaye S, Smyth JF (1996) Pentostatin (2′-deoxycoformycin, dCF) in patients with low-grade (B-T-cell) and intermediate- and high-grade (T-cell) malignant lymphomas: phase II study of the EORTC Early Clinical Trials Group. Oncology 53(2):163–168PubMedCrossRefGoogle Scholar
  23. 23.
    Engels EA (2007) Infectious agents as causes of non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev 16(3):401–404PubMedCrossRefGoogle Scholar
  24. 24.
    Dupuis J, Emile JF, Mounier N, Gisselbrecht C, Martin-Garcia N, Petrella T, Bouabdallah R, Berger F, Delmer A, Coiffier B, Reyes F, Gaulard P (2006) Prognostic significance of Epstein-Barr virus in nodal peripheral T-cell lymphoma, unspecified: a Groupe d’Etude des Lymphomes de l’Adulte (GELA) study. Blood 108(13):4163–4169. doi: 10.1182/blood-2006-04-017632 PubMedCrossRefGoogle Scholar
  25. 25.
    Au WY, Pang A, Choy C, Chim CS, Kwong YL (2004) Quantification of circulating Epstein-Barr virus (EBV) DNA in the diagnosis and monitoring of natural killer cell and EBV-positive lymphomas in immunocompetent patients. Blood 104(1):243–249. doi: 10.1182/blood-2003-12-4197 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Pengpeng Xu
    • 1
  • Dong Yu
    • 1
  • Li Wang
    • 1
  • Yang Shen
    • 1
  • Zhixiang Shen
    • 1
  • Weili Zhao
    • 1
    Email author
  1. 1.State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Shanghai Rui Jin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina

Personalised recommendations