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Multicenter retrospective analysis of the clinicopathologic features of monomorphic epitheliotropic intestinal T-cell lymphoma.
Annals of Hematology ( IF 3.0 ) Pub Date : 2019-09-08 , DOI: 10.1007/s00277-019-03791-y
Jun Ho Yi 1 , Gyeong-Won Lee 2 , Young Rok Do 3 , Hye Ra Jung 4 , Jung Yong Hong 5 , Dok Hyun Yoon 5 , Cheolwon Suh 5 , Yoon Seok Choi 6 , Seong Yoon Yi 7 , Byeong Seok Sohn 8 , Byung-Su Kim 9 , Sung Yong Oh 10 , Jinny Park 11 , Jae-Cheol Jo 12 , Seung-Sook Lee 13 , Young-Ha Oh 14 , Seok Jin Kim 15 , Won Seog Kim 15
Affiliation  

Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a provisional entity in the 2017 World Health Organization classifications. To further elucidate the clinicopathologic features of this new disease, we carried out a retrospective, multicenter analysis of 42 patients with MEITL. The median age of the patients was 59 years (range, 20-84 years), and 27 patients (64 %) were male. Thirty-two patients (76 %) were Ann-Arbor stages I-II and 28 (67 %) were Lugano stages I-II1&2. The most frequent site of involvement was the jejunum (N = 21). Most cases expressed CD8 (79 %) and CD56 (95 %) and did not express CD30 (5 %) or EBER (0 %). The median progression-free survival was 6.9 months (95 % CI 4.3-9.6); the median OS was 14.8 months (2.4-27.2). Thirty-two patients (76 %) underwent surgery and 37 (88 %) received chemotherapy. A complete response (CR) rate was 38 %. Sixteen patients had undergone autologous stem cell transplantation (ASCT). Relapse or progression was documented in 24 cases, most frequently in the primary site (N = 23). Four cases showed central nervous system relapse. Age over 55 years, poor performance scale, advanced Lugano stage (IIE-IV), not achieving CR, and not receiving ASCT were associated with inferior OS. While the optimal management of MEITL remains undetermined, achieving CR and consolidative ASCT seem essential. As CHOP might be insufficient for achieving CR, more efficient combinations should be investigated. Additionally, considering the frequent local failure and CNS relapse, novel therapeutic approaches are required to improve survival.

中文翻译:

多态性回顾性单形上皮性肠T细胞淋巴瘤的临床病理特征。

单形上皮性肠T细胞淋巴瘤(MEITL)是2017年世界卫生组织分类中的临时实体。为了进一步阐明这种新疾病的临床病理特征,我们对42例MEITL患者进行了回顾性,多中心分析。患者的中位年龄为59岁(范围20-84岁),男性为2​​7位患者(64%)。Ann-Arbor I-II期为32例(76%),Lugano I-II1&2期为28(67%)。最常见的受累部位是空肠(N = 21)。大多数病例表达CD8(79%)和CD56(95%),不表达CD30(5%)或EBER(0%)。中位无进展生存期为6.9个月(95%CI 4.3-9.6);中位OS为14.8个月(2.4-27.2)。三十二名患者(76%)接受了手术治疗,而三十七名患者(88%)接受了化疗。完全缓解(CR)率为38%。16例患者接受了自体干细胞移植(ASCT)。记录有24例复发或进展,最常见于原发部位(N = 23)。四例显示中枢神经系统复发。55岁以上的年龄,较差的绩效量表,卢加诺期(IIE-IV)晚期,未达到CR以及未接受ASCT均与OS差有关。尽管MEITL的最佳管理仍未确定,但实现CR和合并ASCT似乎至关重要。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。16例患者接受了自体干细胞移植(ASCT)。记录有24例复发或进展,最常见于原发部位(N = 23)。四例显示中枢神经系统复发。55岁以上的年龄,较差的绩效量表,卢加诺期(IIE-IV)晚期,未达到CR以及未接受ASCT均与OS差有关。尽管MEITL的最佳管理仍未确定,但实现CR和合并ASCT似乎至关重要。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。16例患者接受了自体干细胞移植(ASCT)。记录有24例复发或进展,最常见于原发部位(N = 23)。四例显示中枢神经系统复发。55岁以上的年龄,较差的绩效量表,卢加诺期(IIE-IV)晚期,未达到CR以及未接受ASCT均与OS差有关。尽管MEITL的最佳管理仍未确定,但实现CR和合并ASCT似乎至关重要。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。四例显示中枢神经系统复发。55岁以上的年龄,较差的绩效量表,卢加诺期(IIE-IV)晚期,未达到CR以及未接受ASCT均与OS差有关。尽管MEITL的最佳管理仍未确定,但实现CR和合并ASCT似乎至关重要。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。四例显示中枢神经系统复发。55岁以上的年龄,较差的绩效量表,卢加诺期(IIE-IV)晚期,未达到CR以及未接受ASCT均与OS差有关。尽管MEITL的最佳管理仍未确定,但实现CR和合并ASCT似乎至关重要。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。由于CHOP可能不足以实现CR,因此应研究更有效的组合。此外,考虑到频繁的局部衰竭和中枢神经系统复发,需要新颖的治疗方法来提高生存率。
更新日期:2019-09-06
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