|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
Blood, Vol. 92 No. 1 (July 1), 1998:
pp. 76-82
By
From the Institut d'Hématologie, Hôpital Saint-Louis,
Paris; Département de Pathologie, Hôpital Henri-Mondor,
Créteil; Unité d'Information Médicale, Hôpital
Henri-Mondor, Paris; Service d'Hématologie Clinique, Centre
Hospitalier Lyon Sud, Pierre-Bénite; Service d'Anatomie
Pathologique, Hôpital Necker, Paris; Hôpital de jour
d'Hématologie, Hôpital Henri-Mondor, Créteil;
Service d'Anatomie Pathologique, Hôpital Saint-Louis, Paris;
Institut Paoli-Calmette, Marseille; Centre Henri-Becquerel, Rouen;
Hôpital Edouard-Herriot, Lyon; Institut Paoli-Calmette,
Marseille; Service d'Anatomie Pathologique, Hôtel Dieu, Paris,
France; and Clinique Universitaire de Mont Godinne, Yvoir, Belgium.
Peripheral T-cell lymphomas (PTCL) have been generally reported to
have a worse prognosis than B-cell lymphomas (BCL). Because of their
heterogeneity and scarcity, the outcomes of the different histological
subtypes have not been compared. From October 1987 to March 1993, 1,883 patients with diffuse aggressive non-Hodgkin's lymphomas (NHL)
included in the LNH87 protocol could be assessed for both morphology
and immunophenotyping. Among them, 288 (15%) had PTCL and 1,595 (85%)
had BCL. According to the Kiel classification, most PTCL were
classified as angioimmunoblastic (AIL; 23%), pleomorphic medium and
large T-cell (PML; 49%), or anaplastic large cell (ALCL; 20%)
lymphomas. Comparing PTCL with BCL patients, the former had more
disseminated disease (78% v 58%), B symptoms (57% v
40%), bone marrow involvement (31% v 17%), skin involvement
(21% v 4%), and increased
T-CELL NON-HODGKIN'S lymphomas (NHL) are
rare in Europe and the United States, where they constitute about 15%
to 20% of aggressive lymphomas.1-4 They are more common in
Taiwan and Japan5 and are frequently associated with human
T-lymphotropic virus-I.6,7 They include T-cell lymphomas
expressing an immature prethymic or thymic phenotype, classified as
lymphoblastic lymphomas and T-cell lymphomas of peripheral origin, with
a post-thymic CD1 The prognostic significance of the immunophenotype has been explored in
several studies,2,10-12 and conflicting results have been
reported concerning the outcome of peripheral T-cell lymphomas (PTCL)
compared with that of B-cell lymphomas (BCL). PTCL patients were found
to have equivalent10,5 or poorer prognoses than patients
with BCL.11,12 We previously reported2 that
PTCL were associated with a poor prognosis and that immunophenotype per
se could be an independent adverse prognostic parameter for event-free
survival (EFS). PTCL represent a heterogeneous group of lymphomas, and
a wide variety of different histological subtypes have been
recognized.8,9,13-16 According to the Kiel classification, in our series the most common PTCL is the pleomorphic medium and large-cell lymphoma (PML),8 followed by anaplastic large
cell lymphoma (ALCL),17 angioimmunoblastic lymphoma
(AIL),18,19 and lymphoepithelioid lymphoma. Although it was
suggested that PTCL had low-grade or high-grade histological features,
the prognostic significance of such a distinction has not been
established.8
The International Prognostic Index (IPI) Project20 did not
evaluate the influence of immunophenotype on overall survival (OS),
primarily because of the limited amount of phenotypic data available
and the difficulty of prospectively studying a cohort of PTCL patients
large enough to ensure statistical significance. Recently, the
prognostic value of immunophenotype, using the REAL classification, was
evaluated with stratification of other prognostic factors.3
Although the T-cell phenotype was an independent and significant
prognostic factor, it was not possible to show a statistically
significant effect on OS among the different histological subtypes.
To better define the clinical outcomes of the different subtypes of
T-cell lymphoma, 288 patients with a confirmed T-cell immunophenotype
included in the prospective LNH87 protocol were compared with 1595 BCL
patients of comparable histological grades. The aim of this study was
to evaluate the prognoses of the different entities defined in the Kiel
classification and to compare them with BCL patients with similar
clinical characteristics according to the IPI score.
Patient Selection
Treatment and Assessment of Response
Group 1. This group included 77 PTCL and 351 BCL patients less than 70 years old without any adverse prognostic factors. Patients were randomly assigned to receive 8 cycles every 3 weeks of mBACOD (Adriamycin 45 mg/m2, cyclophosphamide 600 mg/m2, vincristine 1 mg/m2, bleomycin 10 mg/m2 d1, methotrexate 200 mg/m2 d8 and d15, Decadron [Merck Sharp Dohme, Paris, France] d1-5) or 3 courses every 2 weeks of ACVB (Adriamycin [Pharmacia, Guyancourt, France] 75 mg/m2 d1, cyclophosphamide 1,200 mg/m2 d1, vindesine 2 mg/m2 d1, d5, bleomycin 10 mg d1 and d5, prednisone 60 mg/m2 d1-5) followed by the consolidation and maintenance chemotherapies of the LNH84 protocol.21 Group 2. This group included 91 PTCL and 520 BCL patients, 15 to 55 years old, with at least one of the adverse prognostic factors. Patients were randomly assigned to receive 4 cycles of ACVB or 4 courses of NCVB (same as ACVB but with mitoxantrone 12 mg/m2 d1 instead of Adriamycin). Those in complete remission (CR) were randomized between autologous BM transplantation using CVB (cyclophosphamide 1,500 mg/m2 d1-4, Vepesid [Novartis-Pharma, Revil-Malmaison, France] 250 mg/m2 d1-4, Carmustine [BCNU] 300 mg/m2 d4) as conditioning regimen or the classical consolidation and maintenance therapy of the LNH84 protocol.22 Group 3. Group 3 included 80 PTCL and 451 BCL patients, 55 to 70 years old, with at least one adverse prognostic factor. Patients were randomized to receive 4 cycles of ACVB followed by the consolidation and maintenance therapy of LNH84 protocol or 4 alternating induction cycles every 3 weeks of VIM3 (mitoxantrone 10 mg/m2 d1, ifosfamide 1,000 mg/m2 d1-3, Methyl-GAG 300 mg/m2 d1 and d5, Vehem [Novartis-Pharma] 100 mg/m2 d1 and d5, prednisone 60 mg/m2 d1-5, methotrexate 1,500 mg/m2 d14) and ACVB then a maintenance therapy with 4 alternating courses every 3 weeks of VIM (mitoxantrone 10 mg/m2 d1, Vepesid 150 mg/m2 d1-3, ifosfamide 1,000 mg/m2 d1-3) and ACVM (Adriamycin 50 mg/m2 d1, cyclophosphamide 750 mg/m2 d1, vindesine 2 mg/m2 d1, methotrexate 200 mg/m2 d7, d15).23 Group 4. Group 4 included 40 PTCL and 273 BCL patients over 70 years old. They were randomly assigned to receive CVP (cyclophosphamide 750 mg/m2 d1, Vehem 75 mg/m2 d1, prednisone 40 mg/m2 d1-3) or CTVP (same as CVP plus tetrahydropyranyladriamycin 50 mg/m2 d1) for 6 cycles.24 Histological and Immunophenotypic Studies The slides of all patients included in the LNH87 protocol that were initially diagnosed as having PTCL by three independent pathologists were reviewed again by two other independent pathologists (J.D., P.G.). Disagreements were resolved by consensus discussions, usually after additional immunostaining tests. The aims of this second review were (1) to confirm the diagnosis of PTCL and (2) to subclassify them according to the categories of the updated Kiel classification to assess their potential prognostic significance. In addition, some categories of extra nodal T-cell lymphomas recently recognized in the REAL classification mostly based on the site of origin were identified among the included PML category.9
Statistical Analysis
The main clinical and biological characteristics of the 288 PTCL patients with the 1,595 patients with diffuse BCL are listed in Table 2. The median age of the PTCL patients enrolled in the study was 56 years and that of BCL patients was 57 years. Several clinical parameters were significantly more prevalent in PTCL patients; male gender, advanced stage with multiple-node involvement, B symptoms, BM involvement, hepatosplenomegaly, and skin lesions. BCL patients had more localized stage and bulky disease. Significantly more PTCL patients presented with anemia, hypereosinophilia, and hypergammaglobulinemia. A comparison of the main clinical characteristics of the 228 non-ALCL PTCL patients with the 60 patients with T-ALCL are reported in Table 3. These latter tend to have more localized stage with a more favorable IPI score.
Response to Treatment The CR rates were 54% and 63% for T- and B-cell NHL, respectively (P = .005). Partial responses and failures were observed in 20% and 14% of T-cell and 18% and 10% of B-cell NHL. During the induction phase, respectively, 11% and 9% of the patients died. According to univariate analysis, factors affecting the response rate were similar for the T and B subgroups. For T- and B-cell NHL, the CR rates according to the prognostic subgroups defined by the IPI score were similar except for patients with greater than or equal to 3 factors 35% and 52%. Comparisons between other subgroups are reported in Table 3. It should be noted that T-ALCL patients had the best CR rate (72%), which was significantly different from that of the non-ALCL PTCL (49%) (P = .002).Survival The overall 5-year survival rates (Fig 1)differed between PTCL (41%) and BCL (52%) (P = .0004). Comparison between B- and T-cell lymphoma patients was made within the different subgroups of the international prognostic index, and the results are reported in Table 3. A better survival was observed for BCL patients, but differences were significant only for patients with greater than or equal to 2 factors. Comparison between stage III to IV was also significant with a 5-year survival rate of 43% and 33% for BCL and PTCL, respectively (P = .01), but was not significant for stage I to II, 66% and 69% (P = .6). Survival was also analyzed according to the histological subtypes defined by the Kiel classification (Table 4). First, ALCL had a 5-year OS of 64%, which was better than that of any subgroup of T- or B-cell NHL and was superior to non-ALCL PTCL (Fig 2). Second, PML and immunoblastic T-cell lymphoma had significantly lower survival rates when compared with diffuse large (centroblastic and immunoblastic) BCL patients. Third, the remaining subgroup including AIL-like, lymphoepitheliod, and pleomorphic small-cell lymphomas with a 31% probability of survival (Fig 3) had a worse outcome than diffuse mixed B lymphomas (46%). However, this survival was similar to that of the other PML T-cell lymphoma patients (Fig 4). Using non-ALCL T-cell lymphoma as the variable, the international prognostic index was used to stratify the patients (Fig 5). For non-ALCL PTCL patients the OS probability for patients with IPI scores of 0, 1, 2, or 3 were, respectively, 64%, 56%, 34%, and 22%. The difference was significant when compared with BCL patients except for an IPI 1 score.
The 5-year EFS was 32% for PTCL and 45% for BCL
(P = .0001).
This large series of PTCL further emphasizes the morphological heterogeneity of these neoplasms. Classification on the basis of morphology and immunophenotyping is still subject to controversy because of numerous entities included under the name of PTCL. The clear identification of ALCL T-cell lymphomas on the basis of morphology, CD30 antigen expression,17 a common cytotoxic profile,28,29 and a better outcome25 clarifies the situation by separating these lymphomas from the others. Since its recognition in 1978 as an immune disorder, there is also evidence that AIL-like T-cell lymphoma constitutes a distinct PTCL entity, with morphological, phenotypic, and clinical features and a peculiar pattern of EBV30 and cytokines expression.31 In the present study, we further confirm that lymphoepithelioid (Lennert's) lymphoma and T-zone lymphoma are very rare morphological subtypes, often difficult to distinguish from epithelioid-cell-rich AIL or other categories of PTCL.9 About half of the present cases were classified as PML based on the predominance of medium and/or large neoplastic cells. This PML category included several cases of more recently recognized extranodal lymphomas, eg, nasal T-natural killer (NK)-cell lymphomas,32,33 intestinal T-cell lymphomas,34 subcutaneous panniculitis-like T-cell NHL,35 and hepatosplenic gamma-delta T-cell lymphoma.36,37 Altogether, these subgroups represented about 20% of the PML category.
Submitted October 15, 1997;
accepted March 5, 1998.
The authors acknowledge Catherine Balmale and Catherine Belorgey for their invaluable technical assistance, Catherine Barli for preparing the manuscript, and they thank the following clinicians and pathologists who actively participated in the study: I. Abdalsamad, M.F. d'Agay, C. Allard, R. Angonin, J. d'Anjou, B. Audhuy, J. Audouin, G. Auzanneau, A.C. Baglin, C. Bailly, Y. Bastion, E. Baumelou, P. Bensimon, F. Berger, P. Biron, A.M. Blaise, M. Blanc, F. Boman-Ferrand, A. Boehn, J. Boniver, M. Bordes, D. Bordessoule, A. Bosly, R. Bouabdallah, S. Boucheron, J. Bouvier, P. Brice, J. Brière, N. Brousse, P. Brousset, P.A. Bryon, D. Caillot, J.P. Carbillet, R.O. Casasnovas, T. Caulet, D. Cazals, F. Charlotte, L. Charvillat, A.M. Chesneau, B. Christian, B. Coiffier, T. Conroy, J.F. Cordier, C. Cordonnier, J.P. Clauvel, E. Deconinck, M. Delage, A. Delannoy, M. Delos, G. Delsol, A. Devidas, J. Diebold, M. Diviné, H. Dombret, C. Doyen, H. Duplay, B. Dupriez, C. Duval, J.C. Eisenmann, J.M. Emberger, B. Epardeau, B. Fabiani, P. Felman, J.P. Fermand, C. Fermé, A. Ferrand, M. Ffrench, M. Fievez, Y. Fonck, N. Froment, J. Gabarre, P. Galian, O. Gasser, P. Gaulard, C. Gisselbrecht, B. Gosselin, H. Guy, D. Guyotat, C. Haioun, J. Hamels, R. Herbrecht, O. Hopfner, N. Horschowski, F. Huguet, P. Jacomy, J. Jaubert, R. Jeandel, Y. Kerneis, J.P. Knopf, M. Kuentz, E. Labouyrie, B. Lancien, G. Laurent, A. Lavergne, C. Lavignac, V. Leblond, M. Lecomte-Houke, P. Léderlin, F. Lejeune, M.B. Leger-Ravet, R. Loire, R. Marcellin, J.P. Marolleau, G. Marit, C. Martin, C. Marty-Double, A. De Mascarel, S. Méhaut, J.P. Merlio, C. Merignargues, J.M. Micléa, J.L. Michaux, M. Monconduit, P. Morel, F. Morvan, J.F. Mosnier, G. Nédellec, C. Netter-Pinon, H. Noel, C. Nouvel, M. Patey, P.Y. Peaud, G. Perie, M. Peuchmaur, T. Petrella, B. Pignon, C. Platini, M. Pluot, J.P. Pollet, E. Pujade-Lauraine, M. Raphael, M.C. Raymond-Gelle, J. Reiffers, F. Reyes, M. Rochet, J.F. Rossi, A.M. Roucayrol, A. Rozenbaum, G. Salles, H. Schill, C. Sebban, M. Simon, P. Solal-Céligny, P. Straub, E. Suc, L. Sutton, M. Symann, G. Tertian, S. Thiebaut, A. Thyss, H. Tilly, P. Travade, V. Trillet, J.P. Vernant, D. Wendum, and L. Xerri.
1. Greer JP, York JC, Cousar JB, Mitchell RT, Flexner JM, Collins RD, Stein RS: Peripheral T-cell lymphoma: A clinicopathologic study of 42 cases. J Clin Oncol 2:788, 1984[Abstract]
2.
Coiffier B,
Brousse N,
Peuchmaur M,
Berger F,
Gisselbrecht C,
Bryon PA,
Diebold J,
for the GELA:
Peripheral T-cell lymphomas have a worse prognosis than B-cell lymphomas: A prospective study of 361 immunophenotyped patients treated with the LNH84 regimen.
Ann Oncol
1:45,
1990
3.
Melnyk A,
Rodriguez A,
Pugh WC,
Cabanillas F:
Evaluation of the revised European-American lymphoma classification confirms the clinical relevance of immunophenotype in 560 cases of aggressive non-Hodgkin's lymphoma.
Blood
89:4514,
1997
4.
The Non-Hodgkin's Lymphoma Classification Project:
A clinical evaluation of the International Lymphoma Study Group Classification of non-Hodgkin's lymphoma.
Blood
89:3909,
1997 5. Cheng AL, Chen YC, Wang CH, Su IJ, Hsieh HC, Chang JY, Hwang WS, Su WC, Liu TW, Tien HF, Tsai W, Shen MC, Liu CH: Direct comparisons of peripheral T-cell lymphoma with diffuse B-cell lymphoma of comparable histological grades. Should peripheral T-cell lymphoma be considered separately? J Clin Oncol 7:725, 1989[Abstract] 6. Broder S, Bunn PA, Jaffe ES, Blattner W, Gallo RC, Wong-Staal F, Waldmann TA, DeVita VT Jr: T-cell lymphoproliferative syndrome associated with human T-cell leukemia/lymphoma virus. Ann Intern Med 100:543, 1984 7. Shimoyama M: Lymphoma and leukemia of T-lymphocytes , in Sommers SC, Rosen P (eds): Pathology Annual 1981 (part 2). New York, NY, Appleton-Century-Crofts , 1981 , p 155 8. Stansfeld AG, Diebold J, Kapanci Y, Rilke F, Kelenyi G, Sundstrom C, Lennert K, Van Unnik JAM, Mioduszewska O, Wright DH: Updated Kiel classification for lymphomas. Lancet 1:292, 1988[Medline] [Order article via Infotrieve]
9.
Harris NL,
Jaffe ES,
Stein H,
Banks PM,
Chan JKC,
Cleary M,
Delsol G,
De Wolf-Peeters C,
Falini B,
Garter KC,
Grogan TM,
Isaacson PG,
Knowles DM,
Mason DY,
Muller-Hermelink HK,
Pileri SA,
Piris MA,
Ralfkiaer E,
Warnke RA:
A revised European-American classification of lymphoid neoplasm: A proposal from the International Lymphoma Study Group.
Blood
84:1361,
1994 10. Kwak LW, Wilson M, Weiss LM, Goggett R, Dorfman RF, Warnke RA, Horning SJ: Similar outcome of treatment of B-cell and T-cell diffuse large cell lymphomas: The Stanford experience. J Clin Oncol 9:1426, 1991[Abstract] 11. Armitage JO, Vose JM, Linder J, Weisenburger D, Harrington D, Casey J, Bierman P, Sorensen S, Hutchins M, Moravec DF, Howe D, Dowling MD, Mailliard J, Johnson S, Pevnick W, Packard WM, Okerbloom J, Thompson RF, Langdon RM, Soori G, Peterson C, Purtilo D: Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin's lymphoma. J Clin Oncol 7:1783, 1989[Abstract]
12.
Lippman SM,
Miller TP,
Spier CM,
Slymen DJ,
Grogan TM:
The prognostic significance of the immunotype in diffuse large-cell lymphoma: A comparative study of the T-cell and B-cell phenotype.
Blood
72:436,
1988 13. Weiss LM, Crabtree GS, Rouse RV, Warnke RA: Morphologic and immunologic characterization of 50 peripheral T-cell lymphomas. Am J Pathol 118:316, 1985[Abstract]
14.
Liang R,
Todd D,
Chan TK,
Wong KL,
Ho F,
Loke SL:
Peripheral T-cell lymphoma.
J Clin Oncol
5:750,
1987 15. Weisenburger DD, Linder J, Armitage JO: Peripheral T-cell lymphoma: A clinicopathologic study of 42 cases. Hematol Oncol 5:175, 1987[Medline] [Order article via Infotrieve] 16. Pinkus GS, O'Hara CJ, Said JW: Peripheral post-thymic T-cell lymphomas: A spectrum of disease. Cancer 65:971, 1990[Medline] [Order article via Infotrieve]
17.
Stein H,
Mason DY,
Gerdes J,
O'Connor N,
Wainscoat J,
Pallesen G,
Gatter K,
Falini B,
Delsol G,
Lemke H,
Schwarting R,
Lennert K:
The expression of the Hodgkin's disease-associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: Evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells.
Blood
66:848,
1985
18.
Tobinai K,
Minato K,
Ohtsu T,
Murai K,
Kagami Y,
Miwa M,
Watanabe S,
Shimoyama M:
Clinicopathologic, immunophenotypic and immunogenotypic analyses of immunoblastic lymphadenopathy-like T-cell lymphoma.
Blood
72:1000,
1988 19. Nathwani BN, Rappaport H, Moran EM, Pangalis GA, Hun Kim: Malignant lymphoma arising in angioimmunoblastic lymphadenopathy. Cancer 41:578, 1978[Medline] [Order article via Infotrieve]
20.
The International Non-Hodgkin's Lymphoma Prognostic Factors Project:
A predictive model for aggressive non-Hodgkin's lymphoma.
N Engl J Med
329:987,
1993 21. Coiffier B, Gisselbrecht C, Herbrecht R, Tilly H, Bosly A, Brousse N: LNH84 regimen: A multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma. J Clin Oncol 7:1018, 1989[Abstract]
22.
Haioun C,
Lepage E,
Gisselbrecht C,
Bastion Y,
Coiffier B,
Brice P,
Bosly A,
Dupriez B,
Nouvel C,
Tilly H,
Lederlin P,
Biron P,
Brière J,
Gaulard P,
Reyes F:
Benefit of autologous bone marrow transplantation over sequential chemotherapy in poor-risk aggressive non-Hodgkin's lymphoma: Updated results of the prospective study LNH87-2.
J Clin Oncol
15:1131,
1997 23. (abstr) Bosly A, Lepage E, Dupriez B, Herbrecht R, Fillet G, Divine M, Nouvel C, Tilly H, Bordessoule D, Gaulard P, Gisselbrecht C: Alternance of chemotherapy does not improve results in aggressive non-Hodgkin's lymphoma: A prospective randomized study on 884 patients LNH87 protocol group 3: A GELA study. Br J Haematol 83:546, 1996 24. Bastion Y, Blay JY, Divine M, Brice P, Bordessoule D, Sebban C, Blanc M, Tilly H, Lederlin P, Deconinck E, Salles B, Dumontet C, Brière J, Coiffier B: Elderly patients with aggressive lymphoma survive longer if treated with a curative intent. A GELA study on 453 patients older than 69 years. J Clin Oncol 15:2945, 1997[Abstract]
25.
Tilly H,
Gaulard P,
Lepage E,
Dumontet C,
Diebold J,
Plantier I,
Berger F,
Symann M,
Petrella T,
Lederlin P,
Brière J:
Primary anaplastic large-cell lymphoma in adults. Clinical presentation, immunophenotype, and outcome.
Blood
90:3727,
1997 26. Kaplan EL, Meier P: Nonparametric estimation for incomplete observations. J Am Stat Assoc 53:457, 1958 27. Cox DR: Regression models and life-tables. J R Stat Soc 34:187, 1972
28.
Krenacs L,
Wellmann A,
Sorbara L,
Himmelmann AW,
Bagdi E,
Jaffe ES,
Raffeld M:
Cytotoxic cell antigen expression in anaplastic large cells lymphoma of T- and null-cell type and Hodgkin's disease: Evidence for distinct cellular origin.
Blood
89:980,
1997
29.
Foss ES,
Anagnostopoulos I,
Araujo I,
Assaf C,
Demel G,
Kummer JA,
Hummel M,
Stein H:
Anaplastic large-cell lymphomas of T-cell and null-cell phenotype express cytotoxic molecules.
Blood
88:4005,
1996
30.
Weiss LM,
Jaffe ES,
Liu XF,
Chen YY,
Shibata D,
Medeiros LJ:
Detection and localization of Epstein-Barr viral genomes in angioimmunoblastic lymphadenopathy-like lymphoma.
Blood
79:1789,
1992
31.
Foss HD,
Anagnostopoulos I,
Herbst H,
Grebe M,
Ziemann K,
Hummel M,
Stein H:
Patterns of cytokine gene expression in peripheral T-cell lymphoma of angioimmunoblastic lymphadenopathy type.
Blood
85:2862,
1995 32. Jaffe ES, Chan JKC, Ih Jen Su, Frizzera G, Mori S, Feller AC, Ho FCS: Report of the workshop on nasal and related extranodal angiocentric T/natural killer cell lymphomas. Definitions, differential diagnosis and epidemiology. Am J Surg Pathol 20:103, 1996[Medline] [Order article via Infotrieve]
33.
Kanavaros P,
Leses MC,
Brière J,
Divine M,
Galateau,
Joab I,
Bosq J,
Farcet JP,
Reyes F,
Gaulard P:
Nasal T-cell lymphoma: A clinicopathologic entity associated with peculiar phenotype and with Epstein-Barr virus.
Blood
81:2688,
1993 34. Schmitt-Graff A, Hummel M, Zemlin M, Schneider T, Ulrich R, Heise W, Zeit M, Riecken EO, Stein H: Intestinal T-cell lymphoma: A reassessment of cytomorphological and phenotypic features in relation to patterns of small bowel remodeling. Virchows Arch 429:27, 1996[Medline] [Order article via Infotrieve] 35. Gonzalez CL, Medeiros LJ, Braziel RM, Jaffe ES: T-cell lymphoma involving subcutaneous tissue: A clinicopathologic entity commonly associated with hemophagocytic syndrome. Am Surg J Pathol 15:17, 1991 36. Gaulard P, Bourquelot P, Kanavaros P, Haioun C, Le Couedic JP, Divine M, Goossens M, Zafrani ES, Farcet JP, Reyes F: Expression of the alpha/beta and gamma/delta T-cell receptors in 57 cases of peripheral T-cell lymphomas. Identification of a subset of gd T-cell lymphomas. Am J Pathol 137:617, 1990[Abstract]
37.
Cooke CB,
Krenacs L,
Stetler-Stevensen M,
Greiner TC,
Raffeld M,
Kingma DW,
Abruzzo L,
Frantz C,
Kaviani M,
Jaffe ES:
Hepatosplenic T-cell lymphoma: A distinct clinicopathologic entity of cytotoxic gd T-cell origin.
Blood
88:4265,
1996 38. Archimbaud E, Coiffier B, Bryon PA, Vasselon C, Brizard CP, Viala JJ: Prognostic factors in angioimmunoblastic lymphadenopathy. Cancer 59:208, 1987[Medline] [Order article via Infotrieve] 39. Siegert W, Agthe A, Griesser H, Schwerdtfeger R, Brittinger G, Engelhard M, Kuse R, Tiemann M, Lennert K, Huhn D, for the Kiel Lymphoma Study Group: Treatment of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma using prednisone with or without the COMBLAM/IMVP-16 regimen. Ann Intern Med 117:364, 1992 40. Karakas T, Bergman L, Stutte HJ, Jäger E, Knuth A, Weidmann E, Mitrou PS, Hoelzer D: Peripheral T-cell lymphomas respond well to vincristine, adriamycin, cyclophosphamide, prednisone and etoposide (VACPE) and have a similar outcome as high grade B-cell lymphomas. Leuk Lymphoma 24:121, 1996[Medline] [Order article via Infotrieve] 41. Siegert W, Nerl C, Meuthen I, Zahn T, Brack N, Lennert J, Hunn D: Recombinant human interferon-a in the treatment of angioimmunoblastic lymphadenopathy: Results in 12 patients. Leukemia 10:892, 1991
42.
Cheng AL,
Chen CC,
Tien HF,
Lay JD,
Chen BR,
Pu YS,
Hong RL,
Shen MC,
Wang CH,
Chen YC:
Use of retinoic acids in the treatment of peripheral T-cell lymphoma: A pilot study.
J Clin Oncol
12:1185,
1994
43.
Gisselbrecht C,
Maraninchi D,
Pico JL,
Milpied N,
Coiffier B,
Divine M,
Tiberghien P,
Bosly A,
Tilly H,
Boulat O,
Brandely M:
Interleukin-2 treatment in lymphoma: A phase II multicenter study.
Blood
83:2081,
1994 44. Murayama T, Imoto S, Takahashi T, Ito M, Matozaki S, Nakagawa T: Successful treatment of angioimmunoblastic lymphadenopathy with dysproteinemia with cyclosporin A. Cancer 69:2567, 1992[Medline] [Order article via Infotrieve]
© 1998 by The American Society of Hematology.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
|
 |
|
  M. Nickelsen, M. Ziepert, S. Zeynalova, B. Glass, B. Metzner, M. Leithaeuser, H.K. Mueller-Hermelink, M. Pfreundschuh, and N. Schmitz High-dose CHOP plus etoposide (MegaCHOEP) in T-cell lymphoma: a comparative analysis of patients treated within trials of the German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL) Ann. Onc., July 1, 2009; (2009) mdp211v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Reimer, T. Rudiger, E. Geissinger, F. Weissinger, C. Nerl, N. Schmitz, A. Engert, H. Einsele, H. K. Muller-Hermelink, and M. Wilhelm Autologous Stem-Cell Transplantation As First-Line Therapy in Peripheral T-Cell Lymphomas: Results of a Prospective Multicenter Study J. Clin. Oncol., January 1, 2009; 27(1): 106 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Foss Treatment Approaches for Aggressive T-cell Lymphomas ASCO Educational Book, January 1, 2009; 2009(1): 480 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Agostinelli, P P Piccaluga, P Went, M Rossi, A Gazzola, S Righi, T Sista, C Campidelli, P L Zinzani, B Falini, et al. Peripheral T cell lymphoma, not otherwise specified: the stuff of genes, dreams and therapies J. Clin. Pathol., November 1, 2008; 61(11): 1160 - 1167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
International T-Cell Lymphoma Project International Peripheral T-Cell and Natural Killer/T-Cell Lymphoma Study: Pathology Findings and Clinical Outcomes J. Clin. Oncol., September 1, 2008; 26(25): 4124 - 4130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Le Gouill, N. Milpied, A. Buzyn, R. Peffault De Latour, J.-P. Vernant, M. Mohty, M.-P. Moles, K. Bouabdallah, C.-E. Bulabois, J. Dupuis, et al. Graft-Versus-Lymphoma Effect for Aggressive T-Cell Lymphomas in Adults: A Study by the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire J. Clin. Oncol., May 10, 2008; 26(14): 2264 - 2271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Mercadal, J. Briones, B. Xicoy, C. Pedro, L. Escoda, C. Estany, M. Camos, L. Colomo, I. Espinosa, S. Martinez, et al. Intensive chemotherapy (high-dose CHOP/ESHAP regimen) followed by autologous stem-cell transplantation in previously untreated patients with peripheral T-cell lymphoma Ann. Onc., May 1, 2008; 19(5): 958 - 963. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Mourad, N. Mounier, J. Briere, E. Raffoux, A. Delmer, A. Feller, C. J. L. M. Meijer, J.-F. Emile, R. Bouabdallah, A. Bosly, et al. Clinical, biologic, and pathologic features in 157 patients with angioimmunoblastic T-cell lymphoma treated within the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials Blood, May 1, 2008; 111(9): 4463 - 4470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Moarbess, H. El-Hajj, Y. Kfoury, M. E. El-Sabban, Y. Lepelletier, O. Hermine, C. Deleuze-Masquefa, P.-A. Bonnet, and A. Bazarbachi EAPB0203, a member of the imidazoquinoxaline family, inhibits growth and induces caspase-dependent apoptosis in T-cell lymphomas and HTLV-I-associated adult T-cell leukemia/lymphoma Blood, April 1, 2008; 111(7): 3770 - 3777. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kyriakou, C. Canals, A. Goldstone, D. Caballero, B. Metzner, G. Kobbe, H.-J. Kolb, J. Kienast, P. Reimer, J. Finke, et al. High-Dose Therapy and Autologous Stem-Cell Transplantation in Angioimmunoblastic Lymphoma: Complete Remission at Transplantation Is the Major Determinant of Outcome--Lymphoma Working Party of the European Group for Blood and Marrow Transplantation J. Clin. Oncol., January 10, 2008; 26(2): 218 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. Shustov and K. J. Savage Does High-Dose Therapy and Autologous Hematopoietic Stem Cell Transplantation Have a Role in the Primary Treatment of Peripheral T-Cell Lymphomas? Hematology, January 1, 2008; 2008(1): 39 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. de Leval and P. Gaulard Pathobiology and Molecular Profiling of Peripheral T-Cell Lymphomas Hematology, January 1, 2008; 2008(1): 272 - 279. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Savage Prognosis and Primary Therapy in Peripheral T-Cell Lymphomas Hematology, January 1, 2008; 2008(1): 280 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Schmitz, P. Dreger, B. Glass, and A. Sureda Allogeneic transplantation in lymphoma: current status Haematologica, November 1, 2007; 92(11): 1533 - 1548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Rodriguez-Antona, S. Leskela, M. Zajac, M. Cuadros, J. Alves, M. V. Moneo, C. Martin, J. C. Cigudosa, A. Carnero, M. Robledo, et al. Expression of CYP3A4 as a predictor of response to chemotherapy in peripheral T-cell lymphomas Blood, November 1, 2007; 110(9): 3345 - 3351. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kako, K. Izutsu, Y. Ota, Y. Minatani, M. Sugaya, T. Momose, K. Ohtomo, Y. Kanda, S. Chiba, T. Motokura, et al. FDG-PET in T-cell and NK-cell neoplasms Ann. Onc., October 1, 2007; 18(10): 1685 - 1690. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gallamini, F. Zaja, C. Patti, A. Billio, M. R. Specchia, A. Tucci, A. Levis, A. Manna, V. Secondo, L. Rigacci, et al. Alemtuzumab (Campath-1H) and CHOP chemotherapy as first-line treatment of peripheral T-cell lymphoma: results of a GITIL (Gruppo Italiano Terapie Innovative nei Linfomi) prospective multicenter trial Blood, October 1, 2007; 110(7): 2316 - 2323. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Cuadros, S. S. Dave, E. S. Jaffe, E. Honrado, R. Milne, J. Alves, J. Rodriguez, M. Zajac, J. Benitez, L. M. Staudt, et al. Identification of a Proliferation Signature Related to Survival in Nodal Peripheral T-Cell Lymphomas J. Clin. Oncol., August 1, 2007; 25(22): 3321 - 3329. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Rodriguez, E. Conde, A. Gutierrez, J. J. Lahuerta, R. Arranz, A. Sureda, J. Zuazu, A. F. de Sevilla, M. Bendandi, C. Solano, et al. The adjusted International Prognostic Index and {beta}-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma Haematologica, August 1, 2007; 92(8): 1067 - 1074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Rodriguez, E Conde, A Gutierrez, R Arranz, A Leon, J Marin, M Bendandi, C Albo, M. Caballero, and On behalf of the Grupo Espanol de Linfomas/Traspla The results of consolidation with autologous stem-cell transplantation in patients with peripheral T-cell lymphoma (PTCL) in first complete remission: the Spanish Lymphoma and Autologous Transplantation Group experience Ann. Onc., April 1, 2007; 18(4): 652 - 657. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Dupuis, J.-F. Emile, N. Mounier, C. Gisselbrecht, N. Martin-Garcia, T. Petrella, R. Bouabdallah, F. Berger, A. Delmer, B. Coiffier, et al. Prognostic significance of Epstein-Barr virus in nodal peripheral T-cell lymphoma, unspecified: a Groupe d'Etude des Lymphomes de l'Adulte (GELA) study Blood, December 15, 2006; 108(13): 4163 - 4169. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Went, C. Agostinelli, A. Gallamini, P. P. Piccaluga, S. Ascani, E. Sabattini, F. Bacci, B. Falini, T. Motta, M. Paulli, et al. Marker Expression in Peripheral T-Cell Lymphoma: A Proposed Clinical-Pathologic Prognostic Score J. Clin. Oncol., June 1, 2006; 24(16): 2472 - 2479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Greer Therapy of Peripheral T/NK Neoplasms Hematology, January 1, 2006; 2006(1): 331 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mahadevan, C. Spier, K. Della Croce, S. Miller, B. George, C. Riley, S. Warner, T. M. Grogan, and T. P. Miller Transcript profiling in peripheral T-cell lymphoma, not otherwise specified, and diffuse large B-cell lymphoma identifies distinct tumor profile signatures Mol. Cancer Ther., December 1, 2005; 4(12): 1867 - 1879. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Neumann, C. Wagner, K.-D. Preuss, B. Kubuschok, C. Schormann, S. Stevanovic, and M. Pfreundschuh Identification of an epitope derived from the cancer testis antigen HOM-TES-14/SCP1 and presented by dendritic cells to circulating CD4+ T cells Blood, November 1, 2005; 106(9): 3105 - 3113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W.-Y. Au, S.-Y. Ma, C.-S. Chim, C. Choy, F. Loong, A. K. W. Lie, C. C. K. Lam, A. Y. H. Leung, E. Tse, C.-C. Yau, et al. Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years Ann. Onc., February 1, 2005; 16(2): 206 - 214. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Savage Aggressive Peripheral T-Cell Lymphomas (Specified and Unspecified Types) Hematology, January 1, 2005; 2005(1): 267 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Mounier, C. Gisselbrecht, J. Briere, C. Haioun, P. Feugier, F. Offner, C. Recher, A. Stamatoullas, F. Morschhauser, M. Macro, et al. All aggressive lymphoma subtypes do not share similar outcome after front-line autotransplantation: a matched-control analysis by the Groupe d'Etude des Lymphomes de l'Adulte (GELA) Ann. Onc., December 1, 2004; 15(12): 1790 - 1797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Savage, M. Chhanabhai, R. D. Gascoyne, and J. M. Connors Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification Ann. Onc., October 1, 2004; 15(10): 1467 - 1475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Ishida, H. Inagaki, A. Utsunomiya, Y. Takatsuka, H. Komatsu, S. Iida, G. Takeuchi, T. Eimoto, S. Nakamura, and R. Ueda CXC Chemokine Receptor 3 and CC Chemokine Receptor 4 Expression in T-Cell and NK-Cell Lymphomas with Special Reference to Clinicopathological Significance for Peripheral T-Cell Lymphoma, Unspecified Clin. Cancer Res., August 15, 2004; 10(16): 5494 - 5500. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Mounier, C. Gisselbrecht, J. Briere, C. Haioun, P. Feugier, F. Offner, C. Recher, A. Stamatoullas, F. Morschhauser, M. Macro, et al. Prognostic Factors in Patients With Aggressive Non-Hodgkin's Lymphoma Treated by Front-Line Autotransplantation After Complete Remission: A Cohort Study by the Groupe d'Etude des Lymphomes de l'Adulte J. Clin. Oncol., July 15, 2004; 22(14): 2826 - 2834. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Corradini, A. Dodero, F. Zallio, D. Caracciolo, M. Casini, M. Bregni, F. Narni, F. Patriarca, M. Boccadoro, F. Benedetti, et al. Graft-Versus-Lymphoma Effect in Relapsed Peripheral T-Cell Non-Hodgkin's Lymphomas After Reduced-Intensity Conditioning Followed by Allogeneic Transplantation of Hematopoietic Cells J. Clin. Oncol., June 1, 2004; 22(11): 2172 - 2176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Enblad, H. Hagberg, M. Erlanson, J. Lundin, A. P. MacDonald, R. Repp, J. Schetelig, G. Seipelt, and A. Osterborg A pilot study of alemtuzumab (anti-CD52 monoclonal antibody) therapy for patients with relapsed or chemotherapy-refractory peripheral T-cell lymphomas Blood, April 15, 2004; 103(8): 2920 - 2924. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Gallamini, C. Stelitano, R. Calvi, M. Bellei, D. Mattei, U. Vitolo, F. Morabito, M. Martelli, E. Brusamolino, E. Iannitto, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study Blood, April 1, 2004; 103(7): 2474 - 2479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Weidmann, M. Gramatzki, M. Wilhelm, and P. S. Mitrou Diagnosis and actual therapy strategies in peripheral T-cell lymphomas: summary of an international meeting Ann. Onc., March 1, 2004; 15(3): 369 - 374. [Full Text] [PDF]
|
|
|
|
|
|
K. Izutsu, Y. Kanda, H. Ohno, H. Sao, H. Ogawa, Y. Miyazaki, K. Kawa, Y. Kodera, S. Kato, Y. Morishima, et al. Unrelated bone marrow transplantation for non-Hodgkin lymphoma: a study from the Japan Marrow Donor Program Blood, March 1, 2004; 103(5): 1955 - 1960. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Rodriguez, M. D. Caballero, A. Gutierrez, J. Marin, J. J. Lahuerta, A. Sureda, E. Carreras, A. Leon, R. Arranz, A. Fernandez de Sevilla, et al. High-dose chemotherapy and autologous stem cell transplantation in peripheral T-cell lymphoma: the GEL-TAMO experience Ann. Onc., December 1, 2003; 14(12): 1768 - 1775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. W. Bekkenk, M. H. Vermeer, P. M. Jansen, A. M. W. van Marion, M. R. Canninga-van Dijk, P. M. Kluin, M.-L. Geerts, C. J. L. M. Meijer, and R. Willemze Peripheral T-cell lymphomas unspecified presenting in the skin: analysis of prognostic factors in a group of 82 patients Blood, September 15, 2003; 102(6): 2213 - 2219. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Gisselbrecht, E. Lepage, T. Molina, B. Quesnel, G. Fillet, P. Lederlin, B. Coiffier, H. Tilly, J. Gabarre, F. Guilmin, et al. Shortened First-Line High-Dose Chemotherapy for Patients With Poor-Prognosis Aggressive Lymphoma J. Clin. Oncol., May 15, 2002; 20(10): 2472 - 2479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Mounier, D. Simon, C. Haioun, P. Gaulard, C. Gisselbrecht, and I. Khouri Impact of High-Dose Chemotherapy on Peripheral T-Cell Lymphomas J. Clin. Oncol., March 1, 2002; 20(5): 1426 - 1427. [Full Text] [PDF]
|
|
|
|
|
|
T. Rudiger, D. D. Weisenburger, J. R. Anderson, J. O. Armitage, J. Diebold, K. A. MacLennan, B. N. Nathwani, F. Ullrich, and H. K. Muller-Hermelink Peripheral T-cell lymphoma (excluding anaplastic large-cell lymphoma): results from the Non-Hodgkin's Lymphoma Classification Project Ann. Onc., January 19, 2002; 13(1): 140 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. P. Greer, M. C. Kinney, and T. P. Loughran Jr. T Cell and NK Cell Lymphoproliferative Disorders Hematology, January 1, 2001; 2001(1): 259 - 281. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Wirth, H. M. Prince, M. Wolf, U. Machida, M. Kami, H. Hirai, N. Mounier, C. Gisselbrecht, E. Lepage, C. Kosmas, et al. Treatment of Intermediate-Grade and High-Grade Non-Hodgkin's Lymphoma N. Engl. J. Med., November 12, 1998; 339(20): 1475 - 1477. [Full Text]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
 |
 |
|||||||
 |
 |
 |
 |
 |
 |
 |
 |
||
| Copyright © 1998 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
Abstract
Introduction
2-microglobulin (50% v 34%),
whereas BCL patients had more bulky disease (41% v 26%).
According to the International Prognostic Index (IPI), PTCL and BCL
scores were, respectively: 0 factors, 13% and 15%; 1 factor, 17% and
22%; 2 factors, 24% and 25%; 
Abstract
, TdT
,