Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: results from the PETAL consortium

Variances in global access to drugs and treatment practices make it challenging to understand the benefit of contemporary therapies in patients with relapsed and refractory (R/R) mature T-cell and natural killer-cell lymphomas (MTCL and MNKCL). We conducted an international retrospective cohort study of 925 patients with R/R MTCL and MNKCL. In peripheral T-cell lymphoma-not otherwise specified and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK- ALCL), patients with relapsed lymphoma demonstrated a superior median overall survival (OS) relative to refractory from the time of second-line treatment. We identified several independent predictors of OS for R/R lymphoma including age >60 years, primary refractory disease, histological subtype other than angioimmunoblastic T-cell lymphoma (AITL), extranodal sites >1, Ki67 ≥40%, and absolute lymphocyte count less than the lower limit of normal. A multivariable model incorporating these formed the basis for a prognostic index for R/R TCL, in which patients are stratified into low-risk (0-1 risk factor), intermediate-risk (2-3 risk factors), or high-risk (≥4 risk factors) groups, which were associated with 3-year OS of 57.14%, 23.3%, and 7%, respectively. Patients received either a "novel" single agent (SA; 35%) or cytotoxic chemotherapy (CC; 60%) for their second-line treatment. Higher progression-free survival was observed with SA over CC for the entire cohort with a higher 3-year OS in AITL and ALK- ALCL. Among the SA, small-molecule inhibitors demonstrated OS advantage relative to CC in AITL. Our results highlight continued efficacy of novel drugs globally and the potential of a new prediction model in informing heterogeneous prognosis within the R/R population of MTCL and MNKCL.

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Publication Details

Journal
Blood Advances
Published
2024-10-31
DOI
https://doi.org/10.1182/bloodadvances.2024014674
Citations
8
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
3.40

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article

Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: results from the PETAL consortium

Owen A. O’Connor, Mark N Sorial, Noriaki Yoshida, Carlos Chiattone et al.
8 citations
Blood Advances
Lymphoma Diagnosis and Treatment
3.40
article

Global outcomes and prognosis for relapsed/refractory mature T-cell and NK-cell lymphomas: results from the PETAL consortium

Owen A. O’Connor, Mark N Sorial, Noriaki Yoshida, Carlos Chiattone, Mubarak M. Al-Mansour, Ahmed Sawas, Marianna Gentilini, Athina Lymboussaki, Ijeoma Julie Eche, Josie Ford, Govind Bhagat, Hasmukh Jain, Tinatin Muradashvili, Monica Civallero, Ramzi Hamouche, K. Kariya, Jeffrey A. Barnes, Martina Manni, Devavrat Shah, Henry Miles Prince, Sridhar Epari, Massimo Federico, Kusha Chopra, Caroline T. MacVicar, Helen Ma, Alexandra W Lenart, Alok Shetty, Makoto Iwasaki, Mwanasha H. Merrill, Eliana Miranda, Jessy Xinyi Han, Jackielyn Cuenca Alturas, Min Ji Koh, Aditya Ramesh Garg, A. DiSciullo, Estelle Verburgh, Carrie van der Weyden, Changyu Shen, Yu Ri Kim, Amy Ku, Manju Sengar, Sang Eun Yoon, Beatrice Casadei, Won Seog Kim, María José Fernández, Takeshi Okatani, Leora S. Boussi, María Elena Cabrera, Salvia Jain, Min Jung Koh, Sean M. McCabe, Eric D. Jacobsen, Girisha Panchoo, Luke Peng, Robert N. Stuver, Tetiana Skrypets, Thomas Eipe, Shambhavi Singh, Francine M. Foss, Zainab Mohamed, Sarah McCue Horwitz, Pier Luigi Zinzani, Judith Gabler, Jin Seok Kim, Enrica Marchi, Y. Choi, Saswata Saha, Tanuja Shet, Emmanuel Nwodo, Forum Bhanushali
article en
8 citations

Abstract

Variances in global access to drugs and treatment practices make it challenging to understand the benefit of contemporary therapies in patients with relapsed and refractory (R/R) mature T-cell and natural killer-cell lymphomas (MTCL and MNKCL). We conducted an international retrospective cohort study of 925 patients with R/R MTCL and MNKCL. In peripheral T-cell lymphoma-not otherwise specified and anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK- ALCL), patients with relapsed lymphoma demonstrated a superior median overall survival (OS) relative to refractory from the time of second-line treatment. We identified several independent predictors of OS for R/R lymphoma including age >60 years, primary refractory disease, histological subtype other than angioimmunoblastic T-cell lymphoma (AITL), extranodal sites >1, Ki67 ≥40%, and absolute lymphocyte count less than the lower limit of normal. A multivariable model incorporating these formed the basis for a prognostic index for R/R TCL, in which patients are stratified into low-risk (0-1 risk factor), intermediate-risk (2-3 risk factors), or high-risk (≥4 risk factors) groups, which were associated with 3-year OS of 57.14%, 23.3%, and 7%, respectively. Patients received either a "novel" single agent (SA; 35%) or cytotoxic chemotherapy (CC; 60%) for their second-line treatment. Higher progression-free survival was observed with SA over CC for the entire cohort with a higher 3-year OS in AITL and ALK- ALCL. Among the SA, small-molecule inhibitors demonstrated OS advantage relative to CC in AITL. Our results highlight continued efficacy of novel drugs globally and the potential of a new prediction model in informing heterogeneous prognosis within the R/R population of MTCL and MNKCL.

Blood AdvancesVol. 9(3)
Broad Institute (US), University of Modena and Reggio Emilia (IT), Northeastern University (US), Biogen (United States) (US), Beth Israel Deaconess Medical Center (US), Memorial Sloan Kettering Cancer Center (US), Harvard University (US), Emory University (US), University of Cape Town (ZA), The University of Melbourne (AU), University of California, San Francisco (US), Universidade Estadual de Campinas (UNICAMP) (BR), Georgetown University (US), Yonsei University (KR), Homi Bhabha National Institute (IN), University of California, Irvine (US), Radiation Effects Research Foundation (JP), Brown University (US), Columbia University Irving Medical Center (US), Japanese Red Cross Hiroshima College of Nursing (JP), Tata Memorial Hospital (IN), Santa Casa Hospital (BR), Peter MacCallum Cancer Centre (AU), Samsung Medical Center (KR), Groote Schuur Hospital (ZA), King Abdulaziz Medical City (SA), Yale Cancer Center (US), Massachusetts General Hospital (US), Hospital del Salvador (CL), Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital (JP), Dana-Farber Cancer Institute (US), Istituto di Ematologia di Bologna (IT), Azienda USL di Bologna (IT), Istituto Tumori Bari (IT), Gangnam Severance Hospital (KR), VA Long Beach Healthcare System (US), Advanced Centre for Treatment, Research and Education in Cancer (IN), University of Virginia Cancer Center, University of Virginia (US), University of Colorado Anschutz Medical Campus (US), Massachusetts Institute of Technology (US), University of Chile (CL), Sungkyunkwan University (KR), University of Bologna (IT)
National Cancer Institute, Daiichi Sankyo Europe
Good health and well-being
Openalex Percentile: Top 7%
Lymphoma Diagnosis and Treatment
3.40
DOIOpen Access PDFOpenAlex
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