Xiao X.,307 Hospital of Military Medical Science Academy of the PLA |
Lu Y.,307 Hospital of Military Medical Science Academy of the PLA |
Su H.,307 Hospital of Military Medical Science Academy of the PLA |
Zhong K.,307 Hospital of Military Medical Science Academy of the PLA |
And 8 more authors.
Chinese Journal of Clinical Oncology | Year: 2011
Objective: To retrospectively analyze patients with angioimmunoblastic T cell lymphoma (AITL) from a single institution, and to define the clinical features and effect of chemotherapy. Methods: Up to 23 patients with AITL in our department from Sept. 1999 to Sept. 2010 were enrolled, but only 21 patients received treatment. Up to 17 patients received CHOP-like regimens as initial chemotherapy treatments, 4 patients received L-asparaginase (L-asp) + bleomycin + dexamethasone + vindesine regimen; 1 patient was treated with radiotherapy in every group and 1 patient with high-dose chemotherapy followed by autologous stem cell transplantation (HDT-ASCT) in every group as upfront consolidation therapy. Salvage regimen was ICE, DHAP or ProMACE/CytaBOM. Five patients received interferon or combined thalidomide for maintenance therapy; 3 patients received chidamide. Results: The median age of the 23 patients was 60 years; the male to female ratio was 1.9:1. Among all patients, 96% were in Ann Arbor stage III or IV, 57% presented with B symptoms, 22% had splenic involvement or splenomegaly. In terms of laboratory features, 39% had elevated lactate dehydrogenase (LDH), 75% had elevated beta-2 microglobulin (ß2-MG), and D-dimer levels exceeding 255 ng/mL were observed in 80% patients at diagnosis. Immunohistochemistry indicated that the positive rate for CXCL13 was 100% (12/12) and EBER was 80% (8/10). Analysis of the therapeutic effect revealed 7 patients achieved complete remission (CR) and 8 patients achieved partial remission (PR) after initial treatment with CHOP-like regimens; 1 patient achieved CR and 1 patient achieved PR after initial treatment with L-asp-based regimens. The median overall survival (OS) was 27 ( .9-51.1) months, whereas the 3- and 5-year OS was 44% and 29%. Up to 90% of the patients suffered from bone marrow depression III or IV, 33% patients suffered from pneumonia, and 1 patient suffered herpes zoster after chemotherapy. Conclusion: AITL is a distinct subtype of peripheral T-cell lymphoma with unique clinical and pathologic features. In our study, most of the patients had abnormal clotting mechanisms. AITL patients often exhibit immunodeficiency; thus, bone marrow depression and opportunistic infections during therapy cannot be neglected.