Pellatt J, Sweetenham J, Pickering R M, Brown L, Wilkins B
Department of CRC Medical Oncology, University of Southampton and Southampton University NHS Trust and CRC Wessex Medical Oncology Unit, Royal South Hants Hospital, Brinton's Terrace, UK.
Ann Hematol. 2002 May;81(5):267-72. doi: 10.1007/s00277-002-0450-y. Epub 2002 Apr 9.
We conducted a retrospective study of treatment outcomes and survival in 120 consecutive, unselected patients with peripheral T-cell non-Hodgkin's lymphoma, presenting at a single centre over a 20-year period. Cases met the criteria of the Revised European-American Lymphoma (REAL) Classification and patients with peripheral T-cell lymphoma of the following subtypes were included: anaplastic large T-cell lymphoma (ALCL), angioimmunoblastic T-cell lymphoma (AILD), peripheral T-cell lymphoma unspecified (PTCLu), and intestinal T-cell lymphoma (ITCL). The study population consisted of 120 patients with a presenting diagnosis of peripheral T-cell lymphoma. Cases that had been previously confirmed as T-cell lymphoma at formal pathology review were identified from the lymphoma database of this institution. Staging investigations, treatment type and outcomes were taken from patient records. For each subtype, clinical characteristics, response to initial treatment, duration of response and any subsequent relapse were recorded. Overall, relapse, and progression-free survival figures were calculated. The ALCL group had the best response rate to first line treatment 19 of 22 (86 percent) while the AILD group had the lowest response 12 of 29 (41 percent). Relapse rates were PTCLu 13 of 35 (37 percent), ITCL 10 of 34 (29 percent), ALCL 6 of 22 (27 percent) and AILD 7 of 29 (24 percent). In terms of median overall survival, a significantly superior survival was demonstrated for the ALCL group (7.05 years) compared to the remaining three groups. The ALCL group had the lowest risk of death while the ITCL group had the highest risk (hazard ratio: 2.82). Five-year survival rates were estimated to be ALCL 60 percent, PTCLu 40 percent, AILD 30 percent and ITCL 25 percent. This single-centre study demonstrated different outcomes for each group with significant differences in overall survival rates. These findings support the clinical utility of the REAL lymphoma classification in respect to the PTCL subgroups included in this study.
我们对连续收治的120例未经挑选的外周T细胞非霍奇金淋巴瘤患者的治疗结果和生存情况进行了一项回顾性研究,这些患者在20年期间就诊于单一中心。病例符合修订的欧美淋巴瘤(REAL)分类标准,纳入以下亚型的外周T细胞淋巴瘤患者:间变性大T细胞淋巴瘤(ALCL)、血管免疫母细胞性T细胞淋巴瘤(AILD)、未特指的外周T细胞淋巴瘤(PTCLu)和肠道T细胞淋巴瘤(ITCL)。研究人群包括120例初诊为外周T细胞淋巴瘤的患者。通过该机构的淋巴瘤数据库确定那些在正式病理检查中先前已确诊为T细胞淋巴瘤的病例。分期检查、治疗类型和结果取自患者记录。对于每个亚型,记录临床特征、对初始治疗的反应、反应持续时间以及任何后续复发情况。总体上,计算复发率和无进展生存率。ALCL组对一线治疗的反应率最佳,22例中有19例(86%),而AILD组反应率最低,29例中有12例(41%)。复发率分别为:PTCLu组35例中有13例(37%),ITCL组34例中有10例(29%),ALCL组22例中有6例(27%),AILD组29例中有7例(24%)。就中位总生存期而言,与其余三组相比,ALCL组的生存期显著更长(7.05年)。ALCL组死亡风险最低,而ITCL组风险最高(风险比:2.82)。估计5年生存率分别为:ALCL组60%,PTCLu组40%,AILD组30%,ITCL组25%。这项单中心研究表明每组的结果不同,总生存率存在显著差异。这些发现支持了REAL淋巴瘤分类在本研究纳入的PTCL亚组方面的临床实用性。