Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Oncology, Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan, China.
Front Immunol. 2024 Oct 14;15:1481301. doi: 10.3389/fimmu.2024.1481301. eCollection 2024.
To analyze the clinical prognostic factors and treatments for angioimmunoblastic T-cell lymphoma (AITL) and develop a novel prognostic model specifically for AITL.
We retrospectively analyzed 231 patients with AITL from the First Affiliated Hospital of Zhengzhou University. Patients were enrolled between January 2014 and July 2023. The primary end points were overall survival (OS) and progression-free survival (PFS).
The patients' median age was 63 years, with 88.3% at an advanced stage (III/IV). The majority of patients (47.6%) received anthracycline-containing regimens, and there was no significant difference in survival compared with those treated with epigenetic-targeting and gemcitabine- containing regimens. The median PFS and OS were 6 and 17 months, respectively. In multivariate analysis, age >60 years, Eastern Cooperative Oncology Group performance status ≥2, elevated LDH, and splenomegaly were associated with inferior OS. Based on these four factors, a novel prognostic model (AITL model) was constructed that stratified patients into low-, intermediate-, and high-risk groups, with 2-year OS estimates of 63.6%, 42.1%, and 18.6%, respectively.
Currently, there is no consensus on the optimal initial therapy for AITL, and the efficacy of anthracycline-containing regimens remains suboptimal. The novel model developed herein demonstrates predictive significance for both OS and PFS, and exhibits better stratification and discrimination capabilities.
分析血管免疫母细胞性 T 细胞淋巴瘤(AITL)的临床预后因素和治疗方法,并建立一种专门针对 AITL 的新预后模型。
我们回顾性分析了 2014 年 1 月至 2023 年 7 月期间在郑州大学第一附属医院就诊的 231 例 AITL 患者。主要终点是总生存(OS)和无进展生存(PFS)。
患者的中位年龄为 63 岁,晚期(III/IV 期)患者占 88.3%。大多数患者(47.6%)接受了含蒽环类药物的方案治疗,与接受表观遗传学靶向和吉西他滨治疗的患者相比,生存无显著差异。中位 PFS 和 OS 分别为 6 个月和 17 个月。多因素分析显示,年龄>60 岁、东部肿瘤协作组体能状态≥2、LDH 升高和脾肿大与 OS 不良相关。基于这四个因素,构建了一种新的预后模型(AITL 模型),将患者分为低危、中危和高危组,2 年 OS 估计分别为 63.6%、42.1%和 18.6%。
目前,对于 AITL 的最佳初始治疗方案尚未达成共识,含蒽环类药物方案的疗效仍不理想。本研究建立的新模型对 OS 和 PFS 均具有预测意义,且具有更好的分层和区分能力。