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Factors predicting survival in peripheral T‐cell lymphoma in the USA : a population‐based analysis of 8802 patients in the modern era
Author(s) -
Petrich Adam M.,
Helenowski Irene B.,
Bryan Locke J.,
Rozell Shaina A.,
Galamaga Robert,
Nabhan Chadi
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13202
Subject(s) - lymphoma , population , peripheral t cell lymphoma , oncology , medicine , demography , immunology , t cell , environmental health , sociology , immune system
Summary Current prognostic models for peripheral T‐cell lymphoma ( PTCL ) have multiple limitations, and questions exist regarding applicability to current patients. We utilized the Surveillance Epidemiology and End Results ( SEER )‐18 database to evaluate factors affecting overall survival ( OS ) of PTCL in the modern era and identified 8802 patients between 2000–2010. Most subtypes of PTCL increased in incidence during the study period. In univariate analyses, age >55 years, black race, advanced stage, absence of extra‐nodal disease, omission of radiation therapy ( RT ) and high‐risk histology each predicted inferior OS ( P < 0·0001). Multivariate analysis ( MVA ) demonstrated that hepatosplenic, enteropathy‐associated and extra‐nodal Natural Killer/T cell histologies, each had hazard ratios >1·5 ( P ≤ 0·0001) for death. Further, age ≥55 years, black race and advanced stage maintained their significance in the MVA ( P < 0·0001 each). Based on the significant factors, a prognostic model was constructed and subsequently validated in an independent cohort. The new model incorporated age, stage, histology and race, with an OS ranging from 9 months (highest risk group) to 120 months (lowest risk group). In summary, this is the largest study of PTCL patients in the modern era that provides risk stratification utilizing a new prognostic model that can be incorporated into future prospective clinical trials.