Clinical features and prognostic outcomes of angioimmunoblastic T cell lymphoma in an Asian multicenter study

Abstract

In our Asian multicenter retrospective study, we investigated the clinical prognostic factors affecting the outcomes of AITL patients and identified a novel prognostic index relevant in the Asian context. In our 174-patient cohort, the median PFS and OS was 1.8 years and 5.6 years respectively. Age > 60, bone marrow involvement, total white cell count >12 × 10⁹/L and raised serum lactate dehydrogenase were associated with poorer PFS and OS in multivariate analyses. This allowed for a prognostic index (AITL-PI) differentiating patients into low (0-1 factors, n = 64), moderate (2 factors, n = 59) and high-risk (3-4 factors, n = 49) subgroups with 5-year OS of 84.0%, 44.0% and 28.0% respectively (p < 0.0001). POD24 proved to be strongly prognostic (5-year OS 24% vs 89%, p < 0.0001). Exploratory gene expression studies were performed and disparate immune cell profiles and cell signaling signatures were seen in the low risk group as compared to the intermediate and high risk groups.

Keywords:

• Angioimmunoblastic T cell lymphoma
• T follicular helper cell lymphoma
• prognostication
• gene expression analysis
• molecular genetics

Acknowledgements

We would like to thank all subjects who have participated in this study.

Author contributions

EWYC and JYC analyzed the data and drafted the manuscript; EWYC, VSY, SYO, HXK, SDM, EKYN, MLP, YHT, JC, EP, NS, MF, TT, MT, LPK, STL and JYC obtained patient data; BYL, DH, and CKO performed and interpreted the transcriptomic data; EWYC, VSY and JYC designed the study, interpreted the results, and revised the manuscript; and all authors read and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets created and analyzed during this study are available from the corresponding author at [email protected] upon reasonable request.

Additional information

Funding

This work was supported by the NCCS Cancer Fund (Research) [NCCSCF-R-YR2021-JUN-SSD1], Tanoto Foundation Professorship in Medical Oncology, New Century Foundation Limited, Ling Foundation, Singapore Ministry of Health’s National Medical Research Council Research Transition Awards [TA21jun-0005 and TA20nov-0020], Large Collaborative Grant [OFLCG18May-0028], and Collaborative centre grant [TETRAD II].