Open AccessReappraisal of nodal Epstein‐Barr Virus‐negative cytotoxic T‐cell lymphoma: Identification of indolent CD 5 + diseases
Author(s) -
Yamashita Daisuke,
Shimada Kazuyuki,
Takata Katsuyoshi,
MiyataTakata Tomoko,
Kohno Kei,
Satou Akira,
Sakakibara Ayako,
Nakamura Shigeo,
Asano Naoko,
Kato Seiichi
Publication year - 2018
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.13652
Subject(s) - ctl* , lymphoma , t cell receptor , epstein–barr virus , cytotoxic t cell , international prognostic index , immunology , biology , univariate analysis , peripheral t cell lymphoma , medicine , virus , t cell , gastroenterology , pathology , cd8 , antigen , diffuse large b cell lymphoma , multivariate analysis , immune system , biochemistry , in vitro
Nodal cytotoxic molecule ( CM )‐positive peripheral T‐cell lymphoma ( CTL ) has recently been recognized as a clinicopathologically distinct disease. To further characterize this disease, here we compared 58 patients with Epstein‐Barr virus ( EBV )‐negative CTL to 48 patients with EBV ‐positive CTL . The two groups did not differ in histopathology, T‐cell receptor ( TCR ) expression or rearrangement incidences, or survival curves. However, patients with EBV ‐negative CTL less frequently showed hepatic involvement ( P = .007), B symptoms ( P = .020), hemophagocytosis ( P = .024), and detectable CD 4 ( P = .002) and CD 5 ( P = .009). Univariate and multivariate analyses identified three factors that independently predicted favorable survival, onset age <60 years ( P = .002), CD 5 expression ( P = .002), and mixed morphology ( P = .013), TCR αβ was not an independent predictor ( P = .30), but was strongly linked with long survivorship among patients younger than 60 years old. A prognostic model incorporating these factors worked well for prognostic delineation, independently of the International Prognostic Index ( P = .007 vs P = .082) and Prognostic Index for PTCL ( P = .020 vs P = .15). Moreover, this constellation of findings indicated two nodal indolent diseases: CD 5 + TCR αβ (n = 13), and CD 5 + NK ‐cell type lacking TCR expression or clonal TCR γ rearrangement (n = 4). The survival curves for these two groups were significantly superior to others (n = 29, P < .001). These diseases appear to be unique in their indolent clinical behavior, and should be managed differently from other diseases.