TY - JOUR
T1 - Characteristics and clinical outcomes of patients with ALK-positive anaplastic large cell lymphoma
T2 - Report from the prospective international T-cell lymphoma project
AU - Chiattone, Carlos
AU - Civallero, Monica
AU - Fischer, Thais
AU - Miranda, Eliana
AU - Manni, Martina
AU - Zing, Natalia P.C.
AU - Pileri, Stefano A.
AU - Montoto, Silvia
AU - Horwitz, Steven M.
AU - Cabrera, Maria Elena
AU - De Souza, Carmino A.
AU - Nagler, Arnon
AU - Luminari, Stefano
AU - Ferreri, Andrés J.M.
AU - Carson, Kenneth R.
AU - Re, Alessandro
AU - Rigacci, Luigi
AU - Nassi, Luca
AU - Stepanishyna, Yana
AU - Federico, Massimo
AU - Inghirami, Giorgio
N1 - Funding Information:
This study was supported by grants from the Fondazione Cassa di Risparmio di Modena, Modena, Italy; the Associazione Angela Serra per la Ricerca sul Cancro, Modena, Italy; the Fondazione Italiana Linfomi (FIL), Alessandria, Italy; Allos Therapeutics, Inc., Westminster, CO, USA; and Spectrum Pharmaceuticals, Inc., Henderson, NV, USA.
Publisher Copyright:
© 2022 John Wiley & Sons Ltd.
PY - 2022/12
Y1 - 2022/12
N2 - The T-cell Lymphoma Project is an international registry prospective study that enrolled patients with newly diagnosed peripheral T-cell and NK-cell lymphomas (PTCL). The main objective was to define the clinical features and outcomes, establishing a robust benchmark for future clinical trials. Seventy-four institutions from 14 countries in North America, South America, Europe, and Asia collected data on patients diagnosed and treated at their respective centers between September 2006 and February 2018. Among 1553 PTCL patients, 131 (8.4% of the total cohort) were confirmed to have anaplastic large cell lymphoma - kinase positive (ALCL, ALK+). The median age of the patients was 39 years (18–84). Sixty-five patients (66%) had advanced-stage disease, although majority (45 patients, 54%) had a low-risk International Prognostic Index (IPI) score (0–1). Of 97 patients treated with chemotherapy, 97% received anthracycline-containing regimens. The overall response rate was 81%, with 69 patients (70%) achieving complete remission. Estimated OS and PFS at 3 years were 77% (95% CI: 54%–99%) and 68% (95% CI: 46%–90%), respectively, and at 5 years were very similar, 77% of OS (95% CI: 62%–92%) and 64% of PFS (95% CI: 34%–94%). Multivariate analysis for PFS showed advanced stage (hazard ratios [HR]: 4.72, 95% CI: 1.43–23.9, p = 0.015), elevated lactate dehidrogenade (LDH) (HR 4.85; 95% CI: 1.73–13.60, p = 0.001), and Eastern Cooperative Oncology Group Performance Status scale (ECOG-PS) ≥2 (HR: 5.25; 95% CI: 1.68–16.4, p = 0.024). For OS, elevated LDH (HR: 3.77; 95% CI: 1.98–14.17, p = 0.014) and ECOG-PS ≥2 (HR: 4.59; 95% CI: 1.46–14.39, p = 0.004) were identified. In summary, although the outcome of ALK+ ALCL is superior to that of other PTCLs, it remains sufficiently favorable, given the young median age of the patients. Our results confirm the usefulness of both IPI and Prognostic Index for T-cell Lymphoma (PIT) in identifying groups of patients with different outcomes. Clinical Trials ID: NCT01142674.
AB - The T-cell Lymphoma Project is an international registry prospective study that enrolled patients with newly diagnosed peripheral T-cell and NK-cell lymphomas (PTCL). The main objective was to define the clinical features and outcomes, establishing a robust benchmark for future clinical trials. Seventy-four institutions from 14 countries in North America, South America, Europe, and Asia collected data on patients diagnosed and treated at their respective centers between September 2006 and February 2018. Among 1553 PTCL patients, 131 (8.4% of the total cohort) were confirmed to have anaplastic large cell lymphoma - kinase positive (ALCL, ALK+). The median age of the patients was 39 years (18–84). Sixty-five patients (66%) had advanced-stage disease, although majority (45 patients, 54%) had a low-risk International Prognostic Index (IPI) score (0–1). Of 97 patients treated with chemotherapy, 97% received anthracycline-containing regimens. The overall response rate was 81%, with 69 patients (70%) achieving complete remission. Estimated OS and PFS at 3 years were 77% (95% CI: 54%–99%) and 68% (95% CI: 46%–90%), respectively, and at 5 years were very similar, 77% of OS (95% CI: 62%–92%) and 64% of PFS (95% CI: 34%–94%). Multivariate analysis for PFS showed advanced stage (hazard ratios [HR]: 4.72, 95% CI: 1.43–23.9, p = 0.015), elevated lactate dehidrogenade (LDH) (HR 4.85; 95% CI: 1.73–13.60, p = 0.001), and Eastern Cooperative Oncology Group Performance Status scale (ECOG-PS) ≥2 (HR: 5.25; 95% CI: 1.68–16.4, p = 0.024). For OS, elevated LDH (HR: 3.77; 95% CI: 1.98–14.17, p = 0.014) and ECOG-PS ≥2 (HR: 4.59; 95% CI: 1.46–14.39, p = 0.004) were identified. In summary, although the outcome of ALK+ ALCL is superior to that of other PTCLs, it remains sufficiently favorable, given the young median age of the patients. Our results confirm the usefulness of both IPI and Prognostic Index for T-cell Lymphoma (PIT) in identifying groups of patients with different outcomes. Clinical Trials ID: NCT01142674.
KW - ALCL ALK+ lymphoma
KW - PTCL
KW - outcomes
KW - prospective international T-cell lymphoma project
UR - http://www.scopus.com/inward/record.url?scp=85138008968&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85138008968&partnerID=8YFLogxK
U2 - 10.1002/hon.3074
DO - 10.1002/hon.3074
M3 - Article
C2 - 36083035
AN - SCOPUS:85138008968
SN - 0278-0232
VL - 40
SP - 953
EP - 961
JO - Hematological Oncology
JF - Hematological Oncology
IS - 5
ER -
