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

Figures & data

Table 1. Clinical and demographic characteristics of the overall cohort.

Characteristic	N (%)
Total	174 (100)
Age (years)
Median (range)	62.3 (27.1, 88.3)
>60	102 (58.6)
≤60	72 (41.4)
Sex
Male	99 (56.9)
Female	75 (43.1)
Ethnicity
Chinese	126 (72.4)
Malay	18 (10.3)
Indian	7 (4.0)
Others	22 (12.6)
B-symptoms
Absent	81 (46.6)
Present	93 (53.4)
ECOG performance status
0-1	161 (92.5)
2-4	9 (5.2)
Ann Arbor stage
1	14 (8.0)
2	21 (12.1)
3	65 (37.4)
4	71 (40.8)
Extra-nodal site > 1
No	148 (85.1)
Yes	22 (12.6)
Bone marrow involvement
No	101 (58.0)
Yes	57 (32.8)
Raised serum LDH level
No	42 (24.1)
Yes	127 (73.0)
TW > 12 × 10^9/L
No	139 (79.9)
Yes	32 (18.4)
PLT <150,000/mm^3
No	143 (82.2)
Yes	27 (15.5)

ECOG: Eastern cooperative oncology group; LDH: Lactate dehydrogenase; IPI: International Prognostic Index; TW: Total white cell count; PLT: Platelets count.

Missing data: 4 (2.3%) ECOG status, 3 (1.7%) stage, 4 (2.3%) extranodal sites, 16 (9.2%) bone marrow, 5 (2.9%) serum LDH level, 3 (1.7%) TW level, 4 (2.3%) PLT level, 4 (2.3%) IPI score, 3 (1.7%) PIT score, 2 (1.1%) PIAI score.

Figure 1. Survival probabilities of the overall AITL cohort. (A) Kaplan-Meier curve of overall survival of our AITL cohort. (B) AITL survival stratified according to IPI risk groups. (C) AITL survival stratified according to PIT risk groups. (D) AITL survival stratified according to PIAI risk groups.

Table 2. Univariate analysis for overall survival and progression free survival.

Characteristic	Overall survival		Progression free survival
	p value	HR (95% CI)	p value	HR (95% CI)
Age > 60 years	0.0001	2.56 (1.60–4.10)	0.0007	2.02 (1.34–3.04)
Presence of B symptoms	0.0012	2.15 (1.35–3.42)	0.0037	1.81 (1.21–2.72)
ECOG > 1	0.0001	17.56 (4.46–69.07)	< 0.0001	138.85 (28.12–685.45)
Ann Arbor stage 3 – 4	0.0351	1.87 (1.04–3.37)	0.0158	1.83 (1.12–2.99)
Extranodal site > 1	0.4409	1.30 (0.66–2.57)	0.4303	1.27 (0.66–2.26)
Bone marrow involvement	0.0013	2.33 (1.40–3.92)	0.0004	2.31 (1.45–3.68)
LDH > ULN	0.0002	2.63 (1.58–4.37)	<0.0001	2.61 (1.68–4.05)
TW > 12 × 10^9/L	0.0087	2.44 (1.25–4.76)	0.0019	2.51 (1.40–4.50)
PLT < 150,000/mm^3	0.0383	2.15 (1.04–4.44)	0.3117	1.37 (0.74–2.53

HR: hazard ratio, CI: confidence interval, ECOG: Eastern cooperative oncology group, LDH: Lactate dehydrogenase, ULN: Upper limit of normal, TW: Total white cell count, PLT: Platelets count.

Figure 2. Survival probabilities of patients. Overall survival as classified by (A) AITL prognostic index (B) with or without POD24.

Table 3. Multivariate analysis for overall survival and progression free survival.

Characteristic*	Overall survival		Progression free survival
	p value	HR (95% CI)	p value	HR (95% CI)
Age > 60 years	0.0014	2.50 (1.42–4.41)	0.0137	1.83 (1.13–2.97)
Bone marrow involvement	0.0145	1.87 (1.13–3.09)	0.0045	1.89 (1.21–2.93)
TW > 12 × 10^9/L	0.0324	1.88 (1.05–3.37)	0.0099	1.93 (1.17–3.19)
LDH > ULN	0.0211	2.58 (1.15–5.78)	0.0026	2.98 (1.46–6.08)

OS AUC/C-index: 0.722 (95% CI: 0.644–0.791).

PFS AUC/C-index: 0.772 (95%CI: 0.697–0.835).

*Parameters with significance level of < 0.10 in univariate analyses were used in the generation of Multivariate Cox regression models via a backward procedure. ECOG status was not included in view of small numbers of patients with ECOG >1 (n = 9).

Table 4. Comparison of AITL prognostic index with other established prognostic indices.

Prognostic Index	IPI		PIT		PIAI		AITL-PI
Risk group (score)	Low (0-2)	High (3-5)	Low (0-1)	High (2-4)	Low (0-1)	High (2-5)	Low (0-1)	Int. (2)	High (3-4)
N (%)	92 (54.1)	78 (45.9)	71 (41.5)	100 (58.5)	95 (55.2)	77 (44.8)	64 (37.2)	59 (34.3)	49 (28.5)
Median PFS	7.48	0.9	NR	0.84	11.8	0.9	NR	0.9	0.5
5-year PFS (%)	60.5	19.0	66.5	25.0	56.5	24.0	70.0	32.5	16.5
Median OS (years)	14.7	1.7	NR	1.7	14.7	1.7	NR	3.0	1.4
5-year OS (%)	76.0	27.5	82.0	34.5	72.0	32.0	84.0	44.0	28.0
p-value	<0.0001		<0.0001		<0.0001		<0.0001

IPI: International prognostic index; PIT: Prognostic index for T-cell Lymphoma; PIAI: Prognostic Index for AITL; PFS: Progression free survival; OS: Overall survival; NR: Not reached.

Figure 3. Gene expression analysis of patients. (A) Graphs showing gene expression profiling of immune cell types expressed in their raw scores in the AITL cohort stratified according to their risk groups using AITL Prognostic index and (B) Graph showing gene expression analysis of immune cell signaling pathway scores in the AITL cohort stratified according to their risk groups using AITL Prognostic index.

Data availability statement

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