Clinical characteristics and prognostic factors of patients with mature T-cell lymphoid malignancies: a single-institution study of 225 cases

doi:10.1007/s11684-015-0419-6

Frontiers of Medicine

2015, Vol. 9

Issue (4): 468-477 https://doi.org/10.1007/s11684-015-0419-6

本期目录

Clinical characteristics and prognostic factors of patients with mature T-cell lymphoid malignancies: a single-institution study of 225 cases

Wen Xue¹,Yan Sheng¹,Xiangqin Weng¹,Yongmei Zhu¹,Yan Zhao¹,Pengpeng Xu¹,Xiaochun Fei²,Xiaoyan Chen²,Li Wang^1,^*(

),Weili Zhao^1,^*(

)

1. State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
2. Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

全文: PDF(616 KB) HTML

Abstract：

Mature T-cell lymphoid malignancies comprise a group of heterogeneous diseases that vary in clinicopathological features, biological behavior, treatment response, and prognosis. Bone marrow (BM) infiltration is more commonly present in mature T-cell lymphoid malignancies compared with their B-cell counterparts and hence important for differential diagnosis. In this study, clinical characteristics and prognostic factors were analyzed in 225 patients with mature T-cell lymphoid malignancies treated in a single institution. These included 29 cases of T-cell lymphoproliferative disorders (T-LPD, all with BM infiltration) and 196 cases of T-/natural-killer-cell lymphoma (T/NKCL, 56 with BM infiltration and 140 without BM infiltration). The estimated 5-year overall survival (OS) rates of T-LPD and T/NKCL were 96.6% and 37.3%, respectively. T-LPD patients were less likely to exhibit poor performance status, advanced disease stage, presence of B symptoms, or abnormal level of serum β-2 microglobulin. With similar pathological characteristics, T/NKCL patients with BM infiltration showed significantly lower response rates and shorter OS than those without BM infiltration (P = 0.0264 and P<0.0001, respectively). Multivariate analysis indicated that poor performance status, advanced disease stage, elevated serum lactate dehydrogenase level, and BM involvement were independent unfavorable prognostic factors. The Glasgow Prognostic Score may be more efficient than the International Prognostic Index in predicting disease outcome in T/NKCL. In conclusion, clinical characteristics may be useful in more effectively stratifying patients with mature T-cell lymphoid malignancies.

Key words： mature T-cell lymphoid malignancies clonal T-cell population bone marrow infiltration prognostic factors

收稿日期: 2015-02-13 出版日期: 2015-11-26

Corresponding Author(s): Li Wang,Weili Zhao

引用本文:

. [J]. Frontiers of Medicine, 2015, 9(4): 468-477.
Wen Xue,Yan Sheng,Xiangqin Weng,Yongmei Zhu,Yan Zhao,Pengpeng Xu,Xiaochun Fei,Xiaoyan Chen,Li Wang,Weili Zhao. Clinical characteristics and prognostic factors of patients with mature T-cell lymphoid malignancies: a single-institution study of 225 cases. Front. Med., 2015, 9(4): 468-477.

链接本文:

https://academic.hep.com.cn/fmd/CN/10.1007/s11684-015-0419-6
https://academic.hep.com.cn/fmd/CN/Y2015/V9/I4/468

Tab.1

Tab.2

Tab.3

Tab.4

Fig.1

Fig.2

Fig.3

1	Vose J, Armitage J, Weisenburger D; International T-Cell Lymphoma Project. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol 2008; 26(25): 4124–4130 https://doi.org/10.1200/JCO.2008.16.4558 pmid: 18626005
2	Zhao WL. Targeted therapy in T-cell malignancies: dysregulation of the cellular signaling pathways. Leukemia 2010; 24(1): 13–21 https://doi.org/10.1038/leu.2009.223 pmid: 19865108
3	Tang T, Tay K, Quek R, Tao M, Tan SY, Tan L, Lim ST. Peripheral T-cell lymphoma: review and updates of current management strategies. Adv Hematol 2010; 2010: 624040 https://doi.org/10.1155/2010/624040 pmid: 21234357
4	Lima M, Teixeira MA, Queirós ML, Santos AH, Gonçalves C, Correia J, Farinha F, Mendonça F, Soares JM, Almeida J, Orfão A, Justiça B. Immunophenotype and TCR-Vβ repertoire of peripheral blood T-cells in acute infectious mononucleosis. Blood Cells Mol Dis 2003; 30(1): 1–12 https://doi.org/10.1016/S1079-9796(03)00014-7 pmid: 12667982
5	Kroft SH. Monoclones, monotypes, and neoplasia pitfalls in lymphoma diagnosis. Am J Clin Pathol 2004; 121(4): 457–459 https://doi.org/10.1309/RR8AXUWM9FYX178A pmid: 15080295
6	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; Intergruppo Italiano Linfomi. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood 2004; 103(7): 2474–2479 https://doi.org/10.1182/blood-2003-09-3080 pmid: 14645001
7	Weisenburger DD, Savage KJ, Harris NL, Gascoyne RD, Jaffe ES, MacLennan KA, Rüdiger 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; International Peripheral T-cell Lymphoma Project. Peripheral T-cell lymphoma, not otherwise specified: a report of 340 cases from the International Peripheral T-cell Lymphoma Project. Blood 2011; 117(12): 3402–3408 https://doi.org/10.1182/blood-2010-09-310342 pmid: 21270441
8	Vose JM. International Peripheral T-Cell Lymphoma (PTCL) clinical and pathologic review project: poor outcome by prognostic indices and lack of efficacy with anthracyclines. Blood (ASH Annual Meeting Abstracts) 2005; 106: Abstract 811
9	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. Marker expression in peripheral T-cell lymphoma: a proposed clinical-pathologic prognostic score. J Clin Oncol 2006; 24(16): 2472–2479 https://doi.org/10.1200/JCO.2005.03.6327 pmid: 16636342
10	Li YJ, Li ZM, Xia Y, Huang JJ, Huang HQ, Xia ZJ, Lin TY, Li S, Cai XY, Wu-Xiao ZJ, Jiang WQ. Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type. PLoS ONE 2013; 8(5): e64158 https://doi.org/10.1371/journal.pone.0064158 pmid: 23724031
11	Miyazaki T, Yamasaki N, Tsuchiya T, Matsumoto K, Kunizaki M, Taniguchi D, Nagayasu T. Inflammation-based scoring is a useful prognostic predictor of pulmonary resection for elderly patients with clinical stage I non-small-cell lung cancer. Eur J Cardiothorac Surg 2015; 47(4): e140–e145 pmid: 25548132
12	Ishizuka M, Oyama Y, Abe A, Tago K, Tanaka G, Kubota K. Clinical significance of an inflammation-based prognostic system for gastric cancer patients with a preoperative normal serum level of carcinoembryonic antigen. Anticancer Res 2014; 34(12): 7219–7226 pmid: 25503152
13	Li X, Zhang Y, Zhao W, Liu Z, Shen Y, Li J, Shen Z. The Glasgow Prognostic Score as a significant predictor of diffuse large B cell lymphoma treated with R-CHOP in China. Ann Hematol 2015; 94(1): 57–63 https://doi.org/10.1007/s00277-014-2167-0 pmid: 25085376
14	Kim Y, Kim SJ, Hwang D, Jang J, Hyun SY, Kim YR, Kim JS, Min YH, Cheong JW. The modified Glasgow Prognostic Scores as a predictor in diffuse large B cell lymphoma treated with R-CHOP regimen. Yonsei Med J 2014; 55(6): 1568–1575 https://doi.org/10.3349/ymj.2014.55.6.1568 pmid: 25323893
15	Li YJ, Jiang WQ, Huang JJ, Xia ZJ, Huang HQ, Li ZM. The Glasgow Prognostic Score (GPS) as a novel and significant predictor of extranodal natural killer/T-cell lymphoma, nasal type. Am J Hematol 2013; 88(5): 394–399 https://doi.org/10.1002/ajh.23422 pmid: 23423859
16	Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, Harris NL, Le Beau MM, Hellström-Lindberg E, Tefferi A, Bloomfield CD. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood 2009; 114(5): 937–951 https://doi.org/10.1182/blood-2009-03-209262 pmid: 19357394
17	Wang L, Wu-Xiao ZJ, Chen XQ, Zhang YJ, Lu Y, Xia ZJ. Hepatitis B virus infection correlates with poor prognosis of extranodal natural killer/T cell lymphoma. Leuk Lymphoma 2015; 56(4): 936–941 pmid: 25110821
18	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; Groupe d’Etude des Lymphomes de l’Adulte (GELA). 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 2006; 108(13): 4163–4169 https://doi.org/10.1182/blood-2006-04-017632 pmid: 16902151
19	Eminger LA, Hall LD, Hesterman KS, Heymann WR. Epstein-Barr virus: dermatologic associations and implications: part II. Associated lymphoproliferative disorders and solid tumors. J Am Acad Dermatol 2015; 72(1): 21–34, quiz 35−36 https://doi.org/10.1016/j.jaad.2014.07.035 pmid: 25497918
20	de Tute RM. Flow cytometry and its use in the diagnosis and management of mature lymphoid malignancies. Histopathology 2011; 58(1): 90–105 https://doi.org/10.1111/j.1365-2559.2010.03703.x pmid: 21261686
21	Poopak B, Valeshabad AK, Elahi F, Rezvani H, Khosravipour G, Jahangirpour MA, Bolouri S, Golkar T, Salari F, Shahjahani M, Saki N. PCR analysis of IgH and TCR-γ gene rearrangements as a confirmatory diagnostic tool for lymphoproliferative disorders. Indian J Hematol Blood Transfus 2015; 31(1): 38–45 https://doi.org/10.1007/s12288-014-0387-z pmid: 25548443
22	Huang W, Lv N, Ying J, Qiu T, Feng X. Clinicopathological characteristics of four cases of EBV positive T-cell lymphoproliferative disorders of childhood in China. Int J Clin Exp Pathol 2014; 7(8): 4991–4999 pmid: 25197370
23	Kimura H, Ito Y, Kawabe S, Gotoh K, Takahashi Y, Kojima S, Naoe T, Esaki S, Kikuta A, Sawada A, Kawa K, Ohshima K, Nakamura S. EBV-associated T/NK-cell lymphoproliferative diseases in nonimmunocompromised hosts: prospective analysis of 108 cases. Blood 2012; 119(3): 673–686 https://doi.org/10.1182/blood-2011-10-381921 pmid: 22096243
24	Dearden C. Large granular lymphocytic leukaemia pathogenesis and management. Br J Haematol 2011; 152(3): 273–283 https://doi.org/10.1111/j.1365-2141.2010.08494.x pmid: 21158751
25	Nakamichi N, Wada N, Kohara M, Fukuhara S, Sugiyama H, Ogawa H, Hino M, Kanamaru A, Kanakura Y, Morii E, Aozasa K. Polymorphous lymphoproliferative disorder: a clinicopathological analysis. Virchows Arch 2010; 456(3): 269–276 https://doi.org/10.1007/s00428-010-0880-1 pmid: 20111873
26	Miquel J, Fraitag S, Hamel-Teillac D, Molina T, Brousse N, de Prost Y, Bodemer C. Lymphomatoid papulosis in children: a series of 25 cases. Br J Dermatol 2014; 171(5): 1138–1146 https://doi.org/10.1111/bjd.13061 pmid: 24749749
27	Wang XY, Cen XN, Ren HY. Investigation of lymphoma patients’ EBV infection status. Chinese J ExpHematol (Zhongguo Shi Yan Xue Ye Xue Za Zhi) 2014; 22(6): 1584–1590 (in Chinese) pmid: 25543479
28	Desai M, Liu S, Parker S. Clinical characteristics, prognostic factors, and survival of 393 patients with mycosis fungoides and Sézary syndrome in the southeastern United States: a single-institution cohort. J Am Acad Dermatol 2015; 72(2): 276–285 https://doi.org/10.1016/j.jaad.2014.10.019 pmid: 25458019
29	Boi M, Zucca E, Inghirami G, Bertoni F. Advances in understanding the pathogenesis of systemic anaplastic large cell lymphomas. Br J Haematol 2015; 168(6): 771–783 https://doi.org/10.1111/bjh.13265 pmid: 25559471
30	Wang YQ, Yang Y, Zhuo HY, Zou LQ, Jiang Y, Jiang M. Trial of LVDP regimen (L-asparaginase, etoposide, dexamethasone, and cisplatin, followed by radiotherapy) as first-line treatment for newly diagnosed, stage III/IV extranodal natural killer/T cell lymphoma. Med Oncol 2015; 32(2): 435 https://doi.org/10.1007/s12032-014-0435-4 pmid: 25572807

Viewed

Full text

Abstract

Cited

Shared

Discussed