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

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

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 c...

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Main Authors: Jessy Xinyi Han, Min Jung Koh, Leora Boussi, Mark Sorial, Sean M. McCabe, Luke Peng, Shambhavi Singh, Ijeoma Julie Eche-Ugwu, Judith Gabler, Maria J. Fernandez Turizo, Caroline T. MacVicar, Aditya Garg, Alexander Disciullo, Kusha Chopra, Alexandra Lenart, Emmanuel Nwodo, Jeffrey Barnes, Min Ji Koh, Eliana Miranda, Carlos Chiattone, Robert Stuver, Steven M. Horwitz, Mwanasha Merrill, Eric Jacobsen, Martina Manni, Monica Civallero, Tetiana Skrypets, Athina Lymboussaki, Massimo Federico, Yuri Kim, Jin Seok Kim, Jae Yong Cho, Thomas Eipe, Tanuja Shet, Epari Sridhar, Alok Shetty, Saswata Saha, Hasmukh Jain, Manju Sengar, Carrie Van Der Weyden, Henry Miles Prince, Ramzi Hamouche, Tinatin Murdashvili, Francine Foss, Marianna Gentilini, Beatrice Casadei, Pier Luigi Zinzani, Takeshi Okatani, Noriaki Yoshida, Sang Eun Yoon, Won-Seog Kim, Girisha Panchoo, Zainab Mohamed, Estelle Verburgh, Jackielyn Cuenca Alturas, Mubarak Al-Mansour, Josie Ford, Maria Elena Cabrera, Amy Ku, Govind Bhagat, Helen Ma, Ahmed Sawas, Khyati Maulik Kariya, Makoto Iwasaki, Forum Bhanushali, Owen A. O’Connor, Enrica Marchi, Changyu Shen, Devavrat Shah, Salvia Jain
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Blood Advances
Online Access:http://www.sciencedirect.com/science/article/pii/S2473952924006402
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Summary: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.
ISSN:2473-9529

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