Real-world comparison of brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone and anthracycline-based regimens in peripheral T-cell lymphoma: A multicenter retrospective study from the Gifu Hematology Study Group.

Background Brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (BV-CHP) has demonstrated survival benefits over cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in patients with CD30-positive peripheral T-cell lymphoma (PTCL) in a randomized, clinical trial. However, data on the real-world effectiveness of BV-CHP in routine clinical practice remain limited.Methods We conducted a multicenter, retrospective cohort study of patients with newly diagnosed PTCL treated at institutions within the Gifu Hematology Study Group. Patients received BV-CHP, CHOP, or cyclophosphamide, pirarubicin, vincristine, and prednisone (THP-COP) as first-line therapy. Progression-free survival (PFS), overall survival (OS), and overall response rate (ORR) were compared among the treatment groups. Exploratory subgroup analyses were performed, including analyses by bone marrow involvement at diagnosis.Results A total of 154 patients were included: 29 received BV-CHP, 72 received CHOP, and 53 received THP-COP. Overall, no significant differences were observed in PFS, OS, or ORR among the three treatment groups. In exploratory subgroup analyses, patients with bone marrow involvement who were treated with BV-CHP (n = 4) had significantly shorter PFS than those treated with CHOP (n = 17) or THP-COP (n = 15), whereas no significant difference in OS was observed.Conclusions In this real-world multicenter cohort from the Gifu Hematology Study Group, frontline BV-CHP did not demonstrate a survival advantage over CHOP or THP-COP in unselected patients with PTCL. These findings suggest that THP-COP remains a reasonable first-line treatment option in routine clinical practice. The inferior PFS observed in patients with bone marrow involvement treated with BV-CHP should be interpreted cautiously and warrants further investigation.