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2972 Nodal Peripheral T-Cell Lymphoma with T Follicular-Helper Phenotype: A Different Entity? Results of the Spanish Retrospective Real-T Study

Program: Oral and Poster Abstracts
Session: 624. Hodgkin Lymphoma and T/NK Cell Lymphoma—Clinical Studies: Poster III
Hematology Disease Topics & Pathways:
Adult, Diseases, Lymphoma (any), T-Cell Lymphoma, Lymphoid Malignancies, Study Population, Clinically relevant
Monday, December 7, 2020, 7:00 AM-3:30 PM

Alejandro Martin Garcia-Sancho, MD, PhD1*, Socorro María Rodríguez-Pinilla, MD2*, Eva Domingo-Domenech, MD3*, Fina Climent, MD4*, Joaquín Sánchez, MD5*, Javier López Jiménez, MD, PhD6*, Mónica García-Cosío, MD7*, Josep Castellvi, MD8*, Ana Julia González, MD9*, Sonia González de Villambrosia, MD10*, José Gómez Codina, MD11*, Belén Navarro, MD12*, Guillermo Rodríguez, MD13*, Juan José Borrero, MD14*, Máximo Fraga15*, Andrea Naves16*, Lourdes Baeza17* and Raul Córdoba, MD, PhD18

1Hematology Department, Hospital Clínico Universitario de Salamanca, IBSAL, Salamanca, Spain
2Pathology Department, Hospital Universitario Fundación Jiménez Díaz, CIBERONC, Madrid, Spain
3Hematology Department, Institut Catala D'oncologia, L'Hospitalet de Llobregat, Spain
4Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet De Llobregat, Spain
5Hematology Department and Pathology Department, Hospital Universitario Reina Sofía, Córdoba, Andalucía, Spain
6Hematology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
7Anatomical Pathology Department, Hospital Universitario Ramón y Cajal, CIBERONC, Madrid, Spain
8Department of Pathology, University Hospital Vall d'Hebron, Barcelona, Spain
9Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
10Hematology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
11Medical Oncology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
12Hematology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
13Hospital Universitario Virgen del Rocío, Seville, Spain
14Anatomical Pathology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS)/Universidad de Sevilla, Sevilla, Spain
15Pathology Department, Hospital Clínico Universitario Santiago, Santiago de Compostela, Spain
16Medical Department, Takeda Farmacéutica España S.A., Madrid, Spain
17Medical Department, Takeda Farmacéutica España S.A, Madrid, Spain
18Department of Hematology, Fundacion Jimenez Diaz University Hospital, Madrid, Spain

Introduction: Peripheral T-cell lymphomas (PTCL) are a heterogeneous group of mature T-cell neoplasms that generally have an unfavorable prognosis. The 2016 revision of the World Health Organization (WHO) classification includes a new subtype called nodal peripheral T-cell lymphoma with T follicular-helper phenotype (PTCL-TFH), but due to its low frequency and recent definition, its clinical course and prognosis is not well characterized. The aim of this study was to define the clinical characteristics and prognosis of this new PTCL-TFH group compared to PTCL not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL).

Methods: Retrospective observational study carried out in a large series of patients diagnosed with PTCL (n = 175) between 2008 and 2013 in 13 Spanish hospitals. The diagnosis of these patients was centrally reviewed using archived tumor samples, reclassifying patients according to the 2016 WHO criteria. The clinical characteristics and survival of patients with PTCL-NOS, AITL and PTCL-TFH were analyzed.

Results: Of the 175 patients included in the study, 55 were PTCL-NOS and 55 AITL according to the local pathological diagnosis based on WHO 2008 criteria. After centralized review, using WHO 2016 criteria, 21 patients were classified as PTCL-NOS, 55 as AITL, and 23 as PTCL-TFH. Patient characteristics are shown in Table 1. Patients diagnosed with PTCL-TFH had a lower median age and lower-risk baseline characteristics according to IPI (International Prognostic Index) and PIT (Prognostic Index for T-cell lymphoma) indices. No significant differences were found between the three diagnoses in CD30 expression or first-line treatment, which was CHOP or CHOP-like in most patients. A significantly higher percentage of patients in the PTCL-TFH group underwent autologous hematopoietic stem cell transplant (auto-HSCT) (Table 1), the vast majority in the context of first remission (7 out of 9 patients). With a median follow-up of 54.4 months (95% CI 45.69-62.98), estimated by Kaplan‑Meier using the reverse censoring method, both progression-free survival (PFS) and overall survival (OS) were significantly higher in patients with PTCL-TFH than in those with PTCL-NOS and AITL (PFS, 24.6 months vs. 4.6 and 7.8 months, respectively, p = 0.002; OS, 52.6 months vs. 10.0 and 19.3 months, respectively, p < 0.001) (Figure 1). Multivariate analysis revealed that the histological diagnosis maintained its influence on both PFS (PTCL-NOS vs. PTCL-TFH, HR 4.05; AITL vs. PTCL-TFH, HR 2.56) and OS (PTCL-NOS vs. PTCL-TFH, HR 5.68; AITL vs. PTCL-TFH, HR 2.56), regardless of the IPI and PIT indices.

Conclusions: The results of this study support the identification of the PTCL-TFH group as a specific entity, with more favorable clinical features and prognosis than those of the other subtypes. However, these findings should be confirmed in larger patient series.

Disclosures: Martin Garcia-Sancho: Celgene, Eusa Pharma, Gilead, iQuone, Kyowa Kirin, Roche, Morphosys: Consultancy; Roche, Celgene, Janssen, Servier, Gilead: Honoraria. Domingo-Domenech: Janssen: Other: Travel, accomodations and expenses ; Seattle Genetics, Inc.: Research Funding; Roche: Other: Travel, accomodations and expenses ; Bristol-Myers Squibb: Other: Travel, Research Funding; Takeda: Consultancy, Other: Travel, accomodations and expenses , Research Funding. López Jiménez: Gilead: Research Funding, Speakers Bureau; Janssen: Research Funding, Speakers Bureau; Abbvie: Research Funding, Speakers Bureau; Roche: Research Funding, Speakers Bureau; MSD: Speakers Bureau; Takeda: Speakers Bureau. González de Villambrosia: Janssen: Speakers Bureau; Roche: Speakers Bureau. Rodríguez: Celgene: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Roche: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Bristol-Myers Squibb: Consultancy, Speakers Bureau; EUSA Pharma: Consultancy. Naves: Takeda Farmacéutica España S.A.: Current Employment. Baeza: Takeda Farmacéutica España S.A.: Current Employment. Córdoba: Gilead: Honoraria, Other: travel and accommodation; Abbvie: Honoraria, Other: travel and accommodation; Janssen: Honoraria, Other: travel and accommodation; Takeda Farmacéutica España S.A.: Speakers Bureau; Roche: Honoraria, Other: travel and accommodation.

*signifies non-member of ASH