ACTA FAC. MED. NAISS. 2003; 20 (3): 169-173

Original article

CLINICAL PROGNOSTIC FACTORS IN PATIENTS WITH UNSPECIFIED PERIPHERAL T-CELL LYMPHOMA
 

Goran Marjanović¹, Vesna Marjanović², Lana Mačukanović-Golubović¹, Mladen Milenović¹, Bojan Marjanović^{3 1}
Clinic of Hematology and Clinical Immunology, Clinical Center, Niš, ² Clinic of Child Surgery and Orthopedia, Clinical Center, Niš, ³ Clinic of Surgery, Clinical Center, Niš
 

SUMMARY
In order to asses the predictive capacity of various prognostic models in patients with Peripheral T-cell Lymphoma-Unspecified (PTCL-U), we retrospectively analyzed 36 cases fulfilling the criteria defined by the WHO classification.
All patients were diagnosed and treated at the Clinic of Hematology, Clinical Center in Niš, from January 1991 until December 2003, with median follow up of 50 months.
During the first 24 months of follow up, 80.55 % of the patients, with 28.5% of cumulative probability survived during the period of 5 years. The factors significantly associated with the reduced survival in multivariate analysis were: performance status (p=0.014), elevated LDH (p=0.0383), elevated sedimentation rate (ESR) (p=0.045) and complete response vs. no response vs. partial response to therapy (p=0.00395). Univariate analysis showed that age over 60 (p=0.042) adversely influenced survival. International prognostic index (IPI) was able to identify subsets of patients with different prognosis (p=0,047). Prognostic model designed especially for PTCL-U called PIT was able to identify the risk group patients (Log Rank p= 0.041350), while simplified two-class PIT proved to be superior over the simplified two class IPI. (Log Rank p=0.010973 versus p=0.041350). ILI prognostic model, designed for indolent lymphoma (Inter Gruppo Italiano Lymphoma), is not useful in aggressive lymphomas like PTCL-U. (Log Rank p=0.4).
A new therapeutic strategy should be explored for high risk groups of patients identified in PIT model due to their dismal prognosis and a very low 5 year survival.

Key words: peripheral T cell lymphoma unclassified, prognosis, IPI, PIT