Kitsada Wudhikarn1, Udomsak Bunworasate2, Jakrawadee Julamanee3, Arnuparp Lekhakula3, Supachai Ekwattanakit4, Archrob Khuhapinant4, Suporn Chuncharunee5, Pimjai Niparuck5, Tontanai Numbenjapon6, Kannadit Prayongratana6, Nonglak Kanitsap7, Somchai Wongkhantee8, Nisa Makruasi9, Peerapon Wong10, Lalita Norasetthada11, Weerasak Nawarawong11, Chittima Sirijerachai12, Kanchana Chansung12, Tawatchai Suwanban13, Pannee Praditsuktavorn14, Tanin Intragumtornchai15. 1. Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand; Research Collaborations in Hematologic Malignancies and Hematopoietic Stem Cell Transplantation (STAR), Chulalongkorn University, Bangkok, Thailand. Electronic address: kwudhikarn@hotmail.com. 2. Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand; Research Collaborations in Hematologic Malignancies and Hematopoietic Stem Cell Transplantation (STAR), Chulalongkorn University, Bangkok, Thailand. 3. Department of Internal Medicine, Prince of Songkla University, Songkhla, Thailand. 4. Department of Internal Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. 5. Department of Internal Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. 6. Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. 7. Department of Internal Medicine, Thammasart University, Bangkok, Thailand. 8. Department of Internal Medicine, Khonkaen Regional Hospital, Khon Kaen, Thailand. 9. Department of Internal Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand. 10. Department of Internal Medicine, Naresuan University, Phitsanulok, Thailand. 11. Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand. 12. Department of Internal Medicine, Khon Kaen University, Khon Kaen, Thailand. 13. Department of Internal Medicine, Rajavithi Hospital, Bangkok, Thailand. 14. Department of Internal Medicine, Chulabhorn Hospital, Bangkok, Thailand. 15. Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand.
Abstract
INTRODUCTION: Peripheral T cell NHL (PTCL) and natural killer/T cell NHL (NKTCL) are relatively rare disorders. Data on clinical presentation, treatment and outcome are limited especially in older age groups. METHODS: We identified 127 patients with PTCL and NKTCL, excluding cutaneous T/NK cell lymphoma, aged over 60 years old from Thailand nationwide multicenter registry. RESULTS: Of 127 patients, median age of diagnosis was 67 years old. Patients aged older than 75 years old had similar characteristics to younger (60-74 years old) but higher comorbidity index. Seventy-nine patients (62.2%) received intensive/definite multi-agent chemotherapy, however, the proportion was significant lower in older patients (70.4% vs 34.5%, p < .001). After a median follow up duration of 17.3 months, 2-year progression free survival and overall survival were 38.1% and 48.5%. Univariate and multivariable analysis demonstrated older age, poor performance status and absence of definite multi-agent chemotherapy were associated with inferior survival. Definite multi-agent lymphoma specific chemotherapy was an independent factor for overall survival after adjustment for age, comorbidity index, performance status and prognostic index for T cell lymphoma. CONCLUSION: Despite overall poor prognosis of PTCL and NKTCL in older adults, chemotherapy could result in objective response and long-term survival in selected patients of this vulnerable age group thus emphasizing the importance of comprehensive geriatric evaluation.
INTRODUCTION: Peripheral T cell NHL (PTCL) and natural killer/T cell NHL (NKTCL) are relatively rare disorders. Data on clinical presentation, treatment and outcome are limited especially in older age groups. METHODS: We identified 127 patients with PTCL and NKTCL, excluding cutaneous T/NK cell lymphoma, aged over 60 years old from Thailand nationwide multicenter registry. RESULTS: Of 127 patients, median age of diagnosis was 67 years old. Patients aged older than 75 years old had similar characteristics to younger (60-74 years old) but higher comorbidity index. Seventy-nine patients (62.2%) received intensive/definite multi-agent chemotherapy, however, the proportion was significant lower in older patients (70.4% vs 34.5%, p < .001). After a median follow up duration of 17.3 months, 2-year progression free survival and overall survival were 38.1% and 48.5%. Univariate and multivariable analysis demonstrated older age, poor performance status and absence of definite multi-agent chemotherapy were associated with inferior survival. Definite multi-agent lymphoma specific chemotherapy was an independent factor for overall survival after adjustment for age, comorbidity index, performance status and prognostic index for T cell lymphoma. CONCLUSION: Despite overall poor prognosis of PTCL and NKTCL in older adults, chemotherapy could result in objective response and long-term survival in selected patients of this vulnerable age group thus emphasizing the importance of comprehensive geriatric evaluation.
Authors: Maria Christina Cox; Marta Banchi; Sabrina Pelliccia; Arianna Di Napoli; Luigi Marcheselli; Caterina Patti; Paola Anticoli Borza; Roberta Battistini; Francesca Di Gregorio; Paola Orlandi; Guido Bocci Journal: Cancer Chemother Pharmacol Date: 2020-10-18 Impact factor: 3.333