Outcomes and prognostic factors of alternative treatment regimens for angioimmunoblastic T-cell lymphoma: a retrospective analysis.

BACKGROUND

Angioimmunoblastic T-cell lymphoma (AITL), representing the second most prevalent subtype of peripheral T-cell lymphoma, currently lacks standardized frontline therapeutic strategies.

METHODS

In this study, we evaluated the survival outcomes and prognostic factors in 154 patients with AITL treated with one of four regimens: CHOP (cyclophosphamide, vincristine, epirubicin, prednisone), CHOPE (CHOP + etoposide), CPET (chidamide, prednisone, etoposide, thalidomide), or GDPT (gemcitabine, cisplatin, dexamethasone, thalidomide). Among them, 144 patients had complete survival follow-up data. Survival differences across groups were analyzed using the log-rank test, while variations in clinical parameters were assessed via chi-square tests and one-way ANOVA. Univariate and multivariate Cox regression analyses were conducted to identify factors associated with progression-free survival (PFS) and overall survival (OS).

RESULTS

The 5-year OS and PFS rates for the entire cohort were 36.6% (95% CI: 0.275-0.488) and 32.2% (95% CI: 0.233-0.451), respectively. Patients who were younger (<60 or <70 years), had Ann Arbor stage I/II disease, or exhibited lower Eastern Cooperative Oncology Group (ECOG) performance status scores demonstrated significantly improved OS and PFS following treatment. Notably, among patients with ECOG <2, those treated with the CPET regimen achieved longer PFS and OS compared to those receiving CHOP or CHOPE. In contrast, for patients with ECOG ≥2, no significant survival differences were observed across treatment regimens. Both univariate and multivariate analyses identified ECOG performance status as an independent prognostic factor for survival outcomes.

CONCLUSION

For patients with a low ECOG performance status, the CPET regimen may offer promising survival outcomes.