Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Blood. 2012 Mar 22;119(12):2837-43. doi: 10.1182/blood-2011-08-374371. Epub 2012 Feb 2.
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.
血管免疫母细胞性 T 细胞淋巴瘤（AITL）是外周 T 细胞淋巴瘤（PTCL）的主要类型之一。为了阐明日本 AITL 的临床病理特征和预后，我们回顾性分析了 207 例 AITL 患者。患者的中位年龄为 67 岁（范围为 34-91 岁），73%的患者年龄大于 60 岁。在存活患者的中位随访 42 个月中，3 年总生存率（OS）为 54%，无进展生存率（PFS）为 38%。国际预后指数（IPI）和未特指的外周 T 细胞淋巴瘤预后指数（PIT）在本分析中对 OS 具有预测作用。多变量分析发现，年龄大于 60 岁、白细胞（WBC）和 IgA 水平升高、存在贫血和血小板减少以及> 1 个部位的结外累及是 OS 的显著预后因素，而 IgA、贫血和纵隔淋巴结肿大是 PFS 的显著预后因素。成功构建了一个包含 OS 预后因素的新的预后模型。总之，IPI 和 PIT 仍然对 AITL 的预后有帮助，其他因素，包括那些未在 IPI 中使用的因素，如 IgA、贫血、WBC 计数、血小板减少和纵隔淋巴结肿大，也显著影响预后。未来有必要对 IgA 作为一个独特的预后因素进行研究。
