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186 Epidemiology, Clinical Features and Outcomes of Peripheral T-Cell Lymphoma in Latin America

Program: Oral and Poster Abstracts
Type: Oral
Session: 624. Hodgkin Lymphomas and T/NK Cell Lymphomas: Clinical and Epidemiological: Topics in T Cell, Szary and Hodgkin Lymphomas
Hematology Disease Topics & Pathways:
Research, epidemiology, Clinical Practice (Health Services and Quality), Clinical Research, Diversity, Equity, and Inclusion (DEI) , real-world evidence, registries
Saturday, December 9, 2023: 3:15 PM

Thais Fischer, MD1,2*, Henry Idrobo, MD3*, Astrid Pavlovsky, MD4*, Denisse Castro, MD5, Brady Beltran, MD6*, Daniel J Enriquez, MD7*, Jule F Vasquez, MD8, Claudia Roche, MD9*, Daniel Artiles, MD10*, Fabiola Valvert, MD, FRCP11, Luis Mario Villela, MD12*, Juliana Pereira, MD, PhD13, Carolina Oliver, MD14, Jamila Vaz Tavarez, MD15*, Sergio Augusto B Brasil, MD, PhD16*, Karin Z Cecyn, MD17*, Nelson Castro, MD18*, Renata Baptista, MD19*, Samuel de S Medina, MD20*, Davimar Miranda Maciel Borducchi, PhD21, Marcelo Bellesso, MD22*, Danielle Leao Cordeiro De Farias, MD, MSc, MBA23, Yung Bruno Gonzaga, MD24*, Fernando Warley, MSc, MD25*, Lorena Fiad, MD26*, Laura Korin, MD27*, Patricio Hernan Pereyra, PhD28*, Camila Peña, MD29, Maria Alejandra Torres, MD30*, Carolina Valeria Mahuad, MD, PhD31*, Alana Von Glasenapp, MD32*, Alfredo Reinaldo Quiroz, MD32*, Raimundo Gazitua, MD33*, Cesar Augusto Samanez-Figari, MD34*, Lautaro Sardu, MD35*, Juan Pablo Arriola, MD36*, Sebastian Isnardi37*, Juan L. Maradei, MD38*, Raul Hector Gabus, MD39, Alicia I. Enrico, MD40*, Luciana A Guanchiale, PhD41*, Florencia Negri Arangueren, MD42*, Juan Ignacio García Altuve43*, Amalia Cerutti44*, Romina Penalva, MD45*, Jose Ignacio Garcia Trucco46*, Florencia Pessolani47*, Virginia Gilli48*, Joaquin Diaz, MD49*, Maria Enriqueta Martinez, MD50*, Gustavo Jarchum, MD51*, Gabriela Celia Perinotto52*, Teresa Barraza53*, Sergio Ciarlo, MD54*, Christine Rojas, MD55*, Rosa Oliday Rios Jiménez56*, Carmino De Souza, MD, PhD57*, Martina Manni, PhD58*, Eliana C M CM Miranda, PhD, MEd59*, Massimo Federico, MD60, Bryan Valcarcel, MD, MPH61, Carlos Chiattone, MD, PhD62* and Luis Enrique Malpica Castillo, MD63

1Santa Casa de São Paulo Medical School, São Paulo, Brazil
2AC Camargo Cancer Center, Sao Paulo, AC, Brazil
3Universidad del Valle del Cauca, Cali, COL
4Buenos Aires Fundaleu, Buenos Aires, Argentina
5Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
6Hospital Edgardo Rebagliati, Lima, Peru
7Instituto Nacional De Enfermedades Neoplasicas, Lima, Peru
8Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
9Armando Milan Castro, Vila Clara, Cuba
10Arnold Milan Castro Hospital, Vila Clara, Cuba
11ICAN, Ciudad DE Guatemala, Guatemala
12Mexico, Mexico City, Mexico
13University of São Paulo, Department of Hematology, Hemotherapy & Cell Therapy, University of São Paulo, São Paulo, São Paulo, Brazil
14British Hospital, Montevideo, Uruguay
15Ophir Loyola Hospital, Belém, Brazil
16Santa Casa de São Paulo Medical School, Sao Paulo, Brazil
17Federal University of Sao Paulo, Sao Paulo, Brazil
18Hospital de Cancer de Barretos, Barretos, São Paulo, BRA
19State of Rio de Janeiro University, Rio De Janeiro, Brazil
20University of Campinas, São Paulo, BRA
21CEPHO FMABC (Centro de Estudos e Pesquisa em Hematologia e Oncologia)/ Hospital Estadual Mario Covas - Faculdade de Medicina do ABC, Santo Andre, Brazil
22HemoMed, Sao Paulo, Brazil
23Beneficencia Portuguesa Hospital, Sao Paulo, Brazil
24Cancer National Institute- INCA, Rio de Janeiro, Brazil
25Italian Hospital, Buenos Aires, Argentina
26Italian Hospital, La Plata, Argentina
27CABA- Alexander Fleming Institute, Olivos, Argentina
28Hospital Nacional A. Posadas, Buenos Aires, Argentina
29Hospital Del Salvador, Santiago, Chile
30Santa Sofia Clinic, Caracas, Venezuela (Bolivarian Republic of)
31Hospital Aleman, Buenos Aires, Argentina
32Hospital Central IPS, Asuncion, Paraguay
33Arturo Lopez Perez Foundation, Santiago, Chile
34AUNA, Lima, Peru
35Hospital de Alta Complejidad Nestor Kirchner El Cruce, Buenos Aires, Argentina
36Hospital Marie Curie, Caba, Argentina
37HIGA, Buenos Aires, Argentina
38Emilio Ferreyra Hospital, Necochea, Argentina
39Hospital Maciel, Montevideo, Uruguay
40Hospital Italiano de La Plata, La Plata, Argentina
41Cordoba- Hospital Universitario, Vicente Lopez, Argentina
42Hematology Institute, Buenos Aires, Argentina
43CEMIC, Ciudad Autónoma De Bs As, Argentina
44Rosario Sanatorio Britanico, Buenos Aires, Argentina
45Instituto Roffo, CABA, Argentina
46Austral University Hospital, Buenos Aires, Argentina
47Iturraspe Hospital, Santa Fe, Argentina
48Hospital San Martín, Parana, Argentina
49German Clinic, Santiago De Chile, Chile
50Jose San Martin Hospital, CABA, Argentina
51Sanatorio Allende, Córdoba, Argentina
52Justo Jose de Urquiza Hospital, Entre Rios, Argentina
53Angel c Padilla Hospital, Buenos Aires, Argentina
54HECA, Rosario, Argentina
55Dr Gustavo Fricke Hospital, Vina Del Mar, Chile
56Hospital Clínico Quirúrgico Hermanos Amejeiras, La Habana, Cuba
57Hematology and Hemotherapy Center, University of Campinas, Campinas, Brazil
58University of Modena and Reggio Emilia, Modena, ITA
59University of Campinas, Campinas, Brazil
60University of Modena and Reggio Emilia, Modena, Italy
61The George Washington University, Washington, DC
62Santa Casa Medical School, Sao Paolo, Brazil
63Department of Lymphoma and Myeloma, University of Texas MD Anderson cancer Center, Houston, TX

INTRODUCTION: Peripheral T-cell lymphomas (PTCL) represent a rare and heterogenous group of mature T-cell lymphomas often characterized by aggressive behavior. Previous studies evaluating the distribution of PTCL subtypes across Latin America (LATAM) were limited in their representation of most countries in the region. Additionally, a lack of standardized management for several subtypes and the absence of comprehensive lymphoma registries in LATAM suggests exploring real-world treatment patterns and clinical outcomes. We conducted an international pooled analysis to assess the distribution of PTCL across LATAM countries and report treatment outcomes.

METHODS: We compiled data from patients aged ≥18 years with newly diagnosed PTCL from the retrospective registry of the Grupo de Estudio Latinoamericano de Linfoproliferativos (GELL, n=988, 1975-2023), the Brazilian T-cell Project (Brazilian TCP, 2015-2017, 168 cases retrospective; 2017-2023, 425 cases prospective) and the prospective registry of the International T cell Project (ITCP, n=529, 2006-2023). Data were abstracted from medical records in a standardized form. Survival data was only available from the GELL and Brazilian TCP. Overall survival (OS) was estimated from diagnosis to death from any cause, while progression-free survival (PFS) was defined from diagnosis to relapse, progression, or death from any cause. We used the Kaplan-Meier method and Log-rank test to estimate and compare survival probabilities.

RESULTS: We enrolled 2110 patients from 11 LATAM countries. Overall, the median age at diagnosis was 54 years (range 18-95 years), most were male (59%), present with advanced stage disease (Ann Arbor III-IV, 67%), and had good performance status (ECOG ≤1, 71%) (Table 1). After PTCL not otherwise specified (NOS, 39%), adult T-cell leukemia/lymphoma (ATL, 18%) and extranodal NK/T cell lymphoma (ENKTL, 16%) were the most frequently diagnosed PTCL subtypes with varying distribution across LATAM countries. Peru had a higher prevalence of ATL (39%) and ENKTL was frequently diagnosed in Central America (43%). In contrast, ALK-negative (ALK-) anaplastic large T-cell lymphoma (ALCL) was the second more frequent subtype in Brazil (18%), Chile (16%), and Argentina (9%). The percentage of mature T-cell NOS was 27% in Argentina and 28% in Chile. A total of 1620 received chemotherapy. First-line chemotherapy varied across subtypes. Patients with ENKTL were frequently treated with asparaginase/platinum-based therapy (62%), while CHOP was more commonly used for ATL or PTCL NOS (46% for both). Chemotherapy with CHOEP/EPOCH was frequent for patients with ALK- ALCL (45%), ALK+ (ALCL 47%), or AITL (48%).

With a median follow-up of 33 months, the 3-year OS and PFS for the overall cohort were 40% and 30%, respectively. ALK+ ALCL had superior survival estimates, with a 3-year OS of 77% and a 3-year PFS of 73%. The 3-year OS for patients with ENKTL was 48% and the PFS was 45%. Patients with ATL experienced the lowest survival rates (OS and PFS of 23% and 16% at 3 years, respectively). The use of asparaginase/platinum or CHOP-based therapy was associated with superior 3-year OS (61% and 52%, respectively; p=0.011) and PFS (57% and 49%, respectively; p=0.017) among patients with ENKTL. For ATL, the use of CHOEP/EPOCH was associated with improved 3-year OS (21%, p=0.009) and PFS (15%, p=0.024), but outcomes remained dismal.

CONCLUSION: To our knowledge, we report the largest pooled cohort of PTCL subtypes across LATAM by leveraging the retrospective registry of the GELL consortium and data from the Brazilian TCP and ITCP. Our findings suggest a distinct distribution of PTCL subtypes across LATAM countries, with a higher prevalence of ATL and ENKTL compared to the epidemiological patterns in Western countries. This distribution underscores a unique opportunity to increase trial enrollment and accrual of rarer PTCL subtypes. The relatively high percentage of mature T-cell NOS suggests difficulties in providing specific lymphoma diagnoses in the region. The low survival rates for some subtypes indicate the need to develop novel therapies to improve patient outcomes. A larger prospective assessment of PTCL epidemiology and treatment outcomes is being planned to expand the ascertainment of cases, improve pathological classification of the different PTCL subtypes, and validate our results in the LATAM region.

Disclosures: Peña: Janssen: Other: Congress Travel expenses. Gazitua: BMS: Speakers Bureau; Pfizer: Other: Travel; MSD: Research Funding; Roche: Other: Travel; Non-remunerated activity. Enrico: Pfizer: Honoraria. Rojas: Roche: Other: Personal Fees; AstraZeneca: Other: Personal Fees; Janssen: Other: Personal Fees; Novartis: Other: Personal Fees. Chiattone: ROCHE, ABBVIE, JANSSEN, AZ, LYLLI, TAKEDA: Honoraria; ROCHE, ABBVIE, JANSSEN, AZ, LYLLI, TAKEDA: Consultancy.

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