EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA
Objective: To assess the distribution of Peripheral T-cell lymphomas (PTCL) across Latin America (LATAM) countries and report treatment outcomes. Methods: Patients aged ≥18 years with newly diagnosed PTCL from the retrospective registry of the Grupo de Estudio Latinoamericano de Linfoproliferativos...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-10-01
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| Series: | Hematology, Transfusion and Cell Therapy |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137923008787 |
| _version_ | 1827788457551855616 |
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| author | T Fischer H Idrobo A Pavlovsky D Castro B Beltran DJ Enriquez JF Vasquez C Roche D Artiles F Valvert LM Villela J Pereira C Oliver JV Tavares SAB Brasil KZ Cecyn N Castro RLR Baptista SS Medina DMM Borducchi M Bellesso DLC Farias YB Gonzaga F Warley L Fiad L Korin PH Pereyra C Pena MA Torres CV Mahuad AV Glasenapp AR Quiroz R Gazitua CA Samane-Figari L Sardu JP Arriola S Isnardi JL Maradei RH Gabus AI Enrico LA Guanchiale FN Arangueren JIG Altuve A Cerutti R Penalva JIG Trucco F Pessolani V Gilli J Diaz ME Martinez G Jarchum GC Perinotto T Barraza S Ciarlo C Rojas ROR Jiménez CA Souza ECM Miranda M Federico B Valcarcel CS Chiattone LEM Castillo |
| author_facet | T Fischer H Idrobo A Pavlovsky D Castro B Beltran DJ Enriquez JF Vasquez C Roche D Artiles F Valvert LM Villela J Pereira C Oliver JV Tavares SAB Brasil KZ Cecyn N Castro RLR Baptista SS Medina DMM Borducchi M Bellesso DLC Farias YB Gonzaga F Warley L Fiad L Korin PH Pereyra C Pena MA Torres CV Mahuad AV Glasenapp AR Quiroz R Gazitua CA Samane-Figari L Sardu JP Arriola S Isnardi JL Maradei RH Gabus AI Enrico LA Guanchiale FN Arangueren JIG Altuve A Cerutti R Penalva JIG Trucco F Pessolani V Gilli J Diaz ME Martinez G Jarchum GC Perinotto T Barraza S Ciarlo C Rojas ROR Jiménez CA Souza ECM Miranda M Federico B Valcarcel CS Chiattone LEM Castillo |
| author_sort | T Fischer |
| collection | DOAJ |
| description | Objective: To assess the distribution of Peripheral T-cell lymphomas (PTCL) across Latin America (LATAM) countries and report treatment outcomes. Methods: 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), T-cell Brazil Project (Brazilian TCP, ambispective registry 2015-2023, 593 cases) and the prospective International T cell Project (ITCP, n = 529, 2006-2023). Survival data was available from the GELL and Brazilian TCP. Overall survival (OS) was from diagnosis to death from any cause, while progression-free survival (PFS) was diagnosis to relapse, progression, or death from any cause and it was applied Kaplan-Meier method and Log-rank test. Discussion: Previous studies evaluating the distribution of PTCL subtypes across (LATAM) were limited in their representation of most countries in the region, however, now it was conducted an international pooled analysis and 11 countries of LATAM had enrolled. Besides that, 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. Results: a total of 2110 pts from 11 LATAM countries were enrolled. Overall, the median age at dx was 54 years (18-95), 59% male, 67% had advanced stage disease and 29% had ECOG >1. The most frequently diagnosed PTCL subtypes was 39% PTCL not otherwise specified (NOS), 18% adult T-cell leukemia/lymphoma (ATL) and 16% extranodal NK/T cell lymphoma (ENKTL). Peru had a higher prevalence of ATL (39%) and ENKTL (43%) was frequently diagnosed in Central America. In contrast, ALK-negative (ALK-) anaplastic large T-cell lymphoma (ALCL) was the second in Brazil (18%), Chile (16%) and Argentina (9%); T-cell NOS was 28% in Chile and 27% in Argentina. First-line chemotherapy (CT) varied across subtypes and 77% received CT. Pts with ENKTL were frequently treated with asparaginase/platinum-based therapy (62%), while CHOP was used for ATL or PTCL NOS (46% for both). CT with CHOEP/EPOCH was used with ALK- ALCL (45%), ALK+ (47%), or AITL (48%). A median follow-up of 33 months, the 3-year OS and PFS were 40% and 30%, respectively. ALK+ ALCL had superior survival, with 77% OS and 73% of PFS. The ENKTL was 48% of OS and 45% PFS. Pts with ATL had the lowest survival rates (23% OS and 16% PFS). 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 pts 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). Conclusion: To our knowledge, this is the largest pooled cohort of PTCL subtypes across LATAM. Our findings suggest a distinct distribution of PTCL subtypes, with a higher prevalence of ATL and ENKTL compared to the epidemiological patterns in Western countries. The relatively high percentage of PTCL-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. |
| first_indexed | 2024-03-11T17:07:24Z |
| format | Article |
| id | doaj.art-70acf036dabd4e1e89445bd093fcd9df |
| institution | Directory Open Access Journal |
| issn | 2531-1379 |
| language | English |
| last_indexed | 2024-03-11T17:07:24Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj.art-70acf036dabd4e1e89445bd093fcd9df2023-10-20T06:42:45ZengElsevierHematology, Transfusion and Cell Therapy2531-13792023-10-0145S367S368EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICAT Fischer0H Idrobo1A Pavlovsky2D Castro3B Beltran4DJ Enriquez5JF Vasquez6C Roche7D Artiles8F Valvert9LM Villela10J Pereira11C Oliver12JV Tavares13SAB Brasil14KZ Cecyn15N Castro16RLR Baptista17SS Medina18DMM Borducchi19M Bellesso20DLC Farias21YB Gonzaga22F Warley23L Fiad24L Korin25PH Pereyra26C Pena27MA Torres28CV Mahuad29AV Glasenapp30AR Quiroz31R Gazitua32CA Samane-Figari33L Sardu34JP Arriola35S Isnardi36JL Maradei37RH Gabus38AI Enrico39LA Guanchiale40FN Arangueren41JIG Altuve42A Cerutti43R Penalva44JIG Trucco45F Pessolani46V Gilli47J Diaz48ME Martinez49G Jarchum50GC Perinotto51T Barraza52S Ciarlo53C Rojas54ROR Jiménez55CA Souza56ECM Miranda57M Federico58B Valcarcel59CS Chiattone60LEM Castillo61Faculdade de Ciências Médicas da Santa Casa São Paulo (FCMSCSP), São Paulo, Brazil; AC Camargo Câncer Center, São Paulo, BrazilUniversidad del Valle, Valle del Cauca, ColombiaBuenos Aires Fundaleu, Buenos Aires, ArgentinaHospital Nacional Edgardo Rebagliati Martins, PeruHospital Nacional Edgardo Rebagliati Martins, PeruInstituto Nacional De Enfermedades Neoplasicas, PeruInstituto Nacional De Enfermedades Neoplasicas, PeruArmando Milan Castro Hospital, Santa Clara, CubaArmando Milan Castro Hospital, Santa Clara, CubaICAN, Guatemala City, GuatemalaMexico City, MexicoUniversidade de São Paulo (USP), São Paulo, BrazilBritish Hospital, Montevideo, UruguayHospital Ophir Loyola (HOL), Belém, BrazilFaculdade de Ciências Médicas da Santa Casa São Paulo (FCMSCSP), São Paulo, BrazilUniversidade Federal de São Paulo (UNIFESP), São Paulo, BrazilHospital de Câncer de Barretos, Barretos, BrazilUniversidade Estadual do Rio de Janeiro (UERJ) e Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, BrazilUniversidade Estadual de Campinas (UNICAMP), Campinas, BrazilFaculdade de Medicina do ABC (FMABC), Santo André, BrazilHemoMed, Instituto de Ensino e Pesquisa (IEP), São Paulo, BrazilA Beneficência Portuguesa de São Paulo (BP), São Paulo, BrazilInstituto Nacional de Câncer (INCA), Rio de Janeiro, BrazilItalian Hospital, ArgentinaItalian Hospital, ArgentinaCABA- Alexander Fleming Institute, ArgentinaHospital Nacional A. Posadas, ArgentinaHospital Del Salvador, Santiago, ChileSanta Sofia Clinic, Caracas, VenezuelaHospital Aleman, Buenos Aires, ArgentinaHospital Central IPS, ParaguayArturo Lopez Perez Foundation, Santiago, ChileAUNA, Lima, PeruHospital de Alta Complejidad Nestor Kirchner El Cruce, UruguayHospital Marie Curie y Hospital de Clínicas UBA, Caba, ArgentinaHIGA Encarnacion Ezcurra, Buenos Aires, ArgentinaEmilio Ferreyra Hospital, ArgentinaHospital Maciel, Montevideo, UruguayHospital Italiano de La Plata, ArgentinaCordoba- Hospital Universitario, ArgentinaHematology Institute, Buenos Aires, ArgentinaCEMIC, ArgentinaRosario Sanatorio Britanico, Buenos Aires, ArgentinaInstituto Roffo, Caba, ArgentinaAustral University Hospital, Buenos Aires, ArgentinaIturraspe Hospital, ArgentinaHospital San Martín, ArgentinaGerman Clinic, Santiago, ChileJose San Martin Hospital, Caba, ArgentinaSanatorio Allende, Cordoba, ArgentinaJusto Jose de Urquiza Hospital, Entre Rios, ArgentinaAngel c Padilla Hospital, ArgentinaHECA Rosario, ArgentinaDr Gustavo Fricke Hospital Vina Del Mar, ChileHospital Clínico Quirúrgico Hermanos Amejeiras, La Habana, CubaUniversity of Modena and Reggio Emilia, Modena, ItalyUniversidade Estadual de Campinas (UNICAMP), Campinas, BrazilUniversidade Estadual de Campinas (UNICAMP), Campinas, BrazilThe George Washington University, Washington, United StatesHospital Samaritano, São Paulo, BrazilFaculdade de Ciências Médicas da Santa Casa São Paulo (FCMSCSP), São Paulo, Brazil; Department of Lymphoma and Myeloma, University of Texas MD Anderson cancer Center, Houston, United StatesDepartment of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, United StatesObjective: To assess the distribution of Peripheral T-cell lymphomas (PTCL) across Latin America (LATAM) countries and report treatment outcomes. Methods: 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), T-cell Brazil Project (Brazilian TCP, ambispective registry 2015-2023, 593 cases) and the prospective International T cell Project (ITCP, n = 529, 2006-2023). Survival data was available from the GELL and Brazilian TCP. Overall survival (OS) was from diagnosis to death from any cause, while progression-free survival (PFS) was diagnosis to relapse, progression, or death from any cause and it was applied Kaplan-Meier method and Log-rank test. Discussion: Previous studies evaluating the distribution of PTCL subtypes across (LATAM) were limited in their representation of most countries in the region, however, now it was conducted an international pooled analysis and 11 countries of LATAM had enrolled. Besides that, 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. Results: a total of 2110 pts from 11 LATAM countries were enrolled. Overall, the median age at dx was 54 years (18-95), 59% male, 67% had advanced stage disease and 29% had ECOG >1. The most frequently diagnosed PTCL subtypes was 39% PTCL not otherwise specified (NOS), 18% adult T-cell leukemia/lymphoma (ATL) and 16% extranodal NK/T cell lymphoma (ENKTL). Peru had a higher prevalence of ATL (39%) and ENKTL (43%) was frequently diagnosed in Central America. In contrast, ALK-negative (ALK-) anaplastic large T-cell lymphoma (ALCL) was the second in Brazil (18%), Chile (16%) and Argentina (9%); T-cell NOS was 28% in Chile and 27% in Argentina. First-line chemotherapy (CT) varied across subtypes and 77% received CT. Pts with ENKTL were frequently treated with asparaginase/platinum-based therapy (62%), while CHOP was used for ATL or PTCL NOS (46% for both). CT with CHOEP/EPOCH was used with ALK- ALCL (45%), ALK+ (47%), or AITL (48%). A median follow-up of 33 months, the 3-year OS and PFS were 40% and 30%, respectively. ALK+ ALCL had superior survival, with 77% OS and 73% of PFS. The ENKTL was 48% of OS and 45% PFS. Pts with ATL had the lowest survival rates (23% OS and 16% PFS). 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 pts 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). Conclusion: To our knowledge, this is the largest pooled cohort of PTCL subtypes across LATAM. Our findings suggest a distinct distribution of PTCL subtypes, with a higher prevalence of ATL and ENKTL compared to the epidemiological patterns in Western countries. The relatively high percentage of PTCL-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.http://www.sciencedirect.com/science/article/pii/S2531137923008787 |
| spellingShingle | T Fischer H Idrobo A Pavlovsky D Castro B Beltran DJ Enriquez JF Vasquez C Roche D Artiles F Valvert LM Villela J Pereira C Oliver JV Tavares SAB Brasil KZ Cecyn N Castro RLR Baptista SS Medina DMM Borducchi M Bellesso DLC Farias YB Gonzaga F Warley L Fiad L Korin PH Pereyra C Pena MA Torres CV Mahuad AV Glasenapp AR Quiroz R Gazitua CA Samane-Figari L Sardu JP Arriola S Isnardi JL Maradei RH Gabus AI Enrico LA Guanchiale FN Arangueren JIG Altuve A Cerutti R Penalva JIG Trucco F Pessolani V Gilli J Diaz ME Martinez G Jarchum GC Perinotto T Barraza S Ciarlo C Rojas ROR Jiménez CA Souza ECM Miranda M Federico B Valcarcel CS Chiattone LEM Castillo EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA Hematology, Transfusion and Cell Therapy |
| title | EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA |
| title_full | EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA |
| title_fullStr | EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA |
| title_full_unstemmed | EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA |
| title_short | EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOMES OF PERIPHERAL T-CELL LYMPHOMA IN LATIN AMERICA |
| title_sort | epidemiology clinical features and outcomes of peripheral t cell lymphoma in latin america |
| url | http://www.sciencedirect.com/science/article/pii/S2531137923008787 |
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