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Abstract
Background
An angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of lymphoma, accounting for only 1 to 2% of studies on non-Hodgkin's lymphomas. Because of the rarity of this disease, most studies have been small, including cases of various T-cell Non-Hodgkin's Lymphoma (T-NHL). Those patients diagnosed as AITL, during the last 8 years at a single institution (Seoul National University Hospital), were retrospectively analyzed to determine the clinical features and treatment outcomes of AITL.
Methods
All 24 of the patients diagnosed with AITL between February 1995 and February 2003 were included in this retrospective review.
Results
The predominant characteristics of the population were: median age 62 years (range, 32～81); M/F=18/6; nodal involvement 24/24 (100%); extranodal involvement, particularly bone marrow 16/20 (80%); skin involvement 6/24 (25%); B-symptoms 18/24 (75%) and advanced disease (stages III and IV) in 20/24 (83%). Twenty-three of the 24 patients received combination chemotherapy, with 8/23 (35%) of patients obtaining a CR. The median CR duration was 18.1 months. With a median follow-up of 40.9 months, the 5-year OS rate was 28%, with median survival of 8.7 months. According to a univariate analysis, an elevated LDH showed a tendency to negatively influence the survival.
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Table 1.
Relative frequency of histologic subtypes of NHLs according to REAL classification∗
Table 2.
Clinical characteristics of the AITL patients (N=24)
| N | % | |
|---|---|---|
| Age median: 62yr (32～81) | ||
| ≤60yr | 10 | 42 |
| ＞60yr | 14 | 58 |
| Sex | ||
| Males | 18 | 75 |
| Females | 6 | 25 |
| Stage | ||
| I～II | 4 | 17 |
| III～IV | 20 | 83 |
| Performance status | ||
| 1～2 | 18 | 75 |
| 3～4 | 6 | 25 |
| B-symptoms | ||
| Present | 18 | 75 |
| Absent | 6 | 25 |
| LN enlargement | 24 | 100 |
| Hepatosplenomegaly | 16 | 66 |
| Skin | ||
| Rash | 5 | 20 |
| Nodules | 1 | 4 |
| Extranodal involvement | ||
| Bone marrow | 16/20∗ | 80 |
| Pleural effusion | 9 | 38 |
| Ascites | 3 | 13 |
| Cerebrospinal fluid | 0 | 0 |
| IPI | ||
| Low risk | 1 | 4 |
| Low-intermediate | 3 | 13 |
| High-intermediate | 7 | 29 |
| High | 13 | 54 |
Table 3.
Laboratory findings of the AITL patients (N=24)
| N | % | |
|---|---|---|
| Hemoglobin (g/dL) | ||
| ＜10 | 10 | 42 |
| ≥10 | 14 | 58 |
| Hypereosinophilia (＞500/μL) | 8 | 33 |
| Polyclonal hypergammoglobulinemia (＞13g/dL) | 8/12 | 67∗ |
| LDH (IU/L) | ||
| Normal (＜225) | 3 | 12 |
| ～300 | 7 | 29 |
| 301～400 | 7 | 29 |
| 401～500 | 3 | 13 |
| ＞500 | 4 | 17 |
Table 4.
Response according to initial therapy
| First-line therapy | N | CR N (%) | PR N (%) | Median CR duration | Relapse |
|---|---|---|---|---|---|
| Month | N (%) | ||||
| Chemotherapy | 23 | 8 (35) | 4 (17%) | ||
| Anthracycline-based∗ | 16 | 8 (50) | 2 (13%) | 18.1 | 5/8 (62) |
| Others† | 7 | 0 (0) | 2 (29%) |
Table 5.
Prognostic factor rs influencing overa all survival
Table 6.
Comparision of patient characteristics and treatment outcomes
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