Chen Ning-Chun, Chang Hung, Kuo Ming-Chung, Lin Tung-Liang, Shih Lee-Yung, Chuang Wen-Yu, Kao Hsiao-Wen
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan.
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
J Formos Med Assoc. 2024 Feb;123(2):188-197. doi: 10.1016/j.jfma.2023.07.014. Epub 2023 Aug 7.
We aimed to explore the clinical outcomes and prognostic factors for PTCL-NOS patients in the real world.
Clinical data were retrospectively collected from adult patients with PTCL-NOS treated at a single center in Taiwan.
104 PTCL-NOS patients with a median age of 53.0 years were enrolled. Patients with the International Prognostic Index (IPI) or prognostic index for peripheral T-cell lymphoma (PIT) scores of zero had a longer overall survival (OS) and progression free survival (PFS), while patients with IPI or PIT scores ≥1 did poorly. For patients who are eligible for transplantation, the use of pralatrexate as salvage chemotherapy has shown better OS (2-year OS 83.3% vs. 24.4%, P = 0.011) compared to patients who did not. By multivariate analysis, age >60 years, male, B symptoms, ECOG >1, lung involvement, and thrombocytopenia were independent adverse factors for OS. Incorporating factors in multivariate analysis, we established a novel predictive index for PTCL-NOS which efficiently stratifies patients into low (0-1 factor), intermediate-1 (2 factors), intermediate-2 (3 factors), and high risk (4-6 factors) groups with 2-year OS rates of 81.5%, 32.9%, 8.8%, and 0%, respectively (P < 0.001).
PTCL-NOS patients have a dismal prognosis in Taiwan. Novel agents may improve the outcomes of PTCL-NOS patients. The usefulness of the novel prognostic index for PTCL-NOS needs further validation.
我们旨在探讨真实世界中PTCL-NOS患者的临床结局和预后因素。
回顾性收集台湾某单中心治疗的成年PTCL-NOS患者的临床资料。
纳入104例PTCL-NOS患者，中位年龄53.0岁。国际预后指数（IPI）或外周T细胞淋巴瘤预后指数（PIT）评分为零的患者总生存期（OS）和无进展生存期（PFS）更长，而IPI或PIT评分≥1的患者预后较差。对于适合移植的患者，与未使用普拉曲沙作为挽救化疗的患者相比，使用普拉曲沙作为挽救化疗显示出更好的OS（2年OS 83.3%对24.4%，P = 0.011）。多因素分析显示，年龄>60岁、男性、B症状、ECOG>1、肺部受累和血小板减少是OS的独立不良因素。纳入多因素分析中的因素后，我们建立了一种新的PTCL-NOS预测指数，可有效地将患者分为低风险（0-1个因素）、中危-1（2个因素）、中危-2（3个因素）和高风险（4-6个因素）组，2年OS率分别为81.5%、32.9%、8.8%和0%（P < 0.001）。
在台湾，PTCL-NOS患者预后不佳。新型药物可能改善PTCL-NOS患者的结局。PTCL-NOS新预后指数的实用性需要进一步验证。
