Eric D Hsi1, Steven M Horwitz2, Kenneth R Carson3, Lauren C Pinter-Brown4, Steven T Rosen5, Barbara Pro6, Massimo Federico7, Christian Gisselbrecht8, Marc Schwartz9, Lisa A Bellm9, Mark Acosta10, Angela M Collie11, Aaron M Gruver11, Bartosz J Grzywacz11, Samir Turakhia11, Andrei R Shustov12, Ranjana H Advani13, Tatyana Feldman14, Mary Jo Lechowicz15, Sonali M Smith16, Frederick Lansigan17, Anil Tulpule18, Michael D Craig19, John P Greer20, Brad S Kahl21, Joseph W Leach22, Neil Morganstein23, Carla Casulo24, Steven I Park25, Francine M Foss26. 1. Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH. Electronic address: HSIE@ccf.org. 2. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY. 3. Department of Medicine, Washington University, St Louis, MO. 4. Department of Medicine, University of California, Los Angeles, Los Angeles, CA. 5. Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA. 6. Department of Medicine, Thomas Jefferson University, Philadelphia, PA. 7. Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy. 8. Department of Hematology-Oncology, Hôpital Saint Louis, Paris, France. 9. MedNet Solutions, Minnetonka, MN. 10. Research and Development, Spectrum Pharmaceuticals, Inc, Irvine, CA. 11. Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH. 12. Department of Medicine, Fred Hutchinson Cancer Research Center, Seattle, WA. 13. Department of Medicine, Stanford University Medical Center, Stanford, CA. 14. Department of Hematology/Oncology, Hackensack University Medical Center, Hackensack, NJ. 15. Department of Hematology and Oncology, Emory University, Atlanta, GA. 16. Department of Medicine, University of Chicago, Chicago, IL. 17. Department of Medicine, Dartmouth Hitchcock Medical Center, Hanover, NH. 18. Department of Medicine, University of Southern California, Los Angeles, CA. 19. Department of Medicine, West Virginia University, Morgantown, WV. 20. Department of Hematology, Vanderbilt University, Nashville, TN. 21. Department of Medicine, University of Wisconsin, Madison, WI. 22. Minnesota Oncology, Virginia Piper Cancer Institute, Minneapolis, MN. 23. Overlook Medical Center, Summit, NJ. 24. Department of Medicine, University of Rochester, Rochester, NY. 25. Department of Internal Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC. 26. Department of Medical Oncology, Yale University, New Haven, CT.
Abstract
BACKGROUND: With increased understanding of the unique entities, subtype-specific approaches for peripheral T-cell lymphoma (PTCL) are emerging, and more precise diagnoses are becoming increasingly important. PATIENTS AND METHODS: We analyzed the approach to the histopathologic diagnosis of PTCL using data from the comprehensive oncology measures of peripheral T-cell lymphoma (COMPLETE) study. The COMPLETE trial is a large prospective cohort study of patients with newly diagnosed PTCL in the United States. RESULTS: A total of 499 patients were enrolled from 40 academic and 15 community-based centers. Baseline assessment forms were collected for 493 patients, of which 435 (88%) were available for analysis. The most common diagnoses were PTCL, not otherwise specified (PTCL-NOS), anaplastic large cell lymphoma, and angioimmunoblastic T-cell lymphoma (AITL). A mean of 10 markers (range, 0-21) was assessed per patient. CD30 was assessed frequently but not uniformly in cases that were not anaplastic large cell lymphoma. Only 17% of PTCL-NOS cases were assessed for PD1. CXCL13 was a relatively sensitive marker in AITL, expressed in 84% of tested cases; however, only 3% of PTCL-NOS cases were tested. T follicular helper cell marker assessment differed between academic and community practices, with PD1 more often evaluated by academic centers in cases of AITL (62% vs. 12%; P = .01). CONCLUSION: The diagnostic workup for PTCL in the United States varies widely and often lacks important phenotypic information to fully characterize the lymphoma. Gaps in testing of selected markers should be filled, given the impending revision to the World Health Organization classification. The accuracy of diagnosis will become increasingly important as we enter the era of targeted treatment for PTCL.
BACKGROUND: With increased understanding of the unique entities, subtype-specific approaches for peripheral T-cell lymphoma (PTCL) are emerging, and more precise diagnoses are becoming increasingly important. PATIENTS AND METHODS: We analyzed the approach to the histopathologic diagnosis of PTCL using data from the comprehensive oncology measures of peripheral T-cell lymphoma (COMPLETE) study. The COMPLETE trial is a large prospective cohort study of patients with newly diagnosed PTCL in the United States. RESULTS: A total of 499 patients were enrolled from 40 academic and 15 community-based centers. Baseline assessment forms were collected for 493 patients, of which 435 (88%) were available for analysis. The most common diagnoses were PTCL, not otherwise specified (PTCL-NOS), anaplastic large cell lymphoma, and angioimmunoblastic T-cell lymphoma (AITL). A mean of 10 markers (range, 0-21) was assessed per patient. CD30 was assessed frequently but not uniformly in cases that were not anaplastic large cell lymphoma. Only 17% of PTCL-NOS cases were assessed for PD1. CXCL13 was a relatively sensitive marker in AITL, expressed in 84% of tested cases; however, only 3% of PTCL-NOS cases were tested. T follicular helper cell marker assessment differed between academic and community practices, with PD1 more often evaluated by academic centers in cases of AITL (62% vs. 12%; P = .01). CONCLUSION: The diagnostic workup for PTCL in the United States varies widely and often lacks important phenotypic information to fully characterize the lymphoma. Gaps in testing of selected markers should be filled, given the impending revision to the World Health Organization classification. The accuracy of diagnosis will become increasingly important as we enter the era of targeted treatment for PTCL.
Authors: Steven I Park; Steven M Horwitz; Francine M Foss; Lauren C Pinter-Brown; Kenneth R Carson; Steven T Rosen; Barbara Pro; Eric D Hsi; Massimo Federico; Christian Gisselbrecht; Marc Schwartz; Lisa A Bellm; Mark Acosta; Ranjana H Advani; Tatyana Feldman; Mary Jo Lechowicz; Sonali M Smith; Frederick Lansigan; Anil Tulpule; Michael D Craig; John P Greer; Brad S Kahl; Joseph W Leach; Neil Morganstein; Carla Casulo; Andrei R Shustov Journal: Cancer Date: 2019-01-29 Impact factor: 6.860
Authors: Min Jung Koh; Mwanasha H Merrill; Min Ji Koh; Robert Stuver; Carolyn D Alonso; Francine M Foss; Angel M Mayor; John Gill; Marta Epeldegui; Edward Cachay; Jennifer E Thorne; Michael J Silverberg; Michael A Horberg; Keri N Althoff; Ank E Nijhawan; Kathleen A McGinnis; Jennifer S Lee; Charles S Rabkin; Sonia Napravnik; Jun Li; Jessica L Castilho; Changyu Shen; Salvia Jain Journal: Blood Adv Date: 2022-03-08