TCL-637: Outcome of peripheral T-Cell lymphomas-not otherwise specified (PTCL-NOS): An analysis from Northern India

Abstract

Context: Peripheral T-cell lymphomas (PTCLs) represent a diverse category of non-Hodgkin lymphomas (NHLs), with PTCLnot otherwise specified (PTCL-NOS) being the predominant variant. Objective: This study aimed to present data on the demographics and outcomes of patients with PTCL who received treatment at a single institution in North India. Design, Setting, and Participants: This study was conducted on patients aged ≥18 years diagnosed with PTCL-NOS from January 2014 to December 2023 at AIIMS in New Delhi. Data regarding clinical characteristics, treatment modalities, tumor response, and survival outcomes were retrospectively obtained. Results: A total of 90 patients were recruited during the study period, and 80 patients were taken for response evaluation and outcome analysis. The median age was 46 years (range 18–81 years). An intermediate- to high- international prognosis index (IPI) score was 66.25%, bone marrow involvement was 12.5%, extranodal involvement was 60%, and elevated LDH was 50%. Moreover, 70% of patients had B symptoms and advanced (stage III/IV), and 60% had a performance status (PS) of >1. The majority of patients received anthracycline-based multiagent chemotherapy and etoposide-based chemotherapy. Complete remission (CR) rate was 70%, while the overall response rate was 82.3%. Only 12 patients underwent stem cell transplantation due to various logistical reasons. The median follow-up duration was 27 months. The 5-year event-free survival and overall survival rates were 35% and 44%, respectively. Univariate analyses indicated that performance status >1, age ≥60 years, serum albumin levels <3.5 g/dL, failure to achieve complete remission, extranodal involvement, and the presence of B symptoms were significantly correlated with poorer survival outcomes. In the multivariate analysis, only serum albumin levels <3.5 g/dL and failure to achieve CR significantly impacted survival. Two patients received brentuximab vedotin for advanced disease without autologous stem cell transplant and at the time of our analysis were in remission. Conclusions: Patients with PTCL in our Northern India cohort tend to present at a younger age and with more advanced disease stages compared with patients from Western countries. The poor prognosis for PTCL patients in our cohort emphasizes the need for standardized procedures for prompt diagnosis, referral, and treatment.