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EVENT FREE SURVIVAL AT 12 MONTHS AND 24 MONTHS AS PREDICTORS FOR OUTCOME OF SYSTEMIC PERIPHERAL T CELL LYMPHOMA: ANALYSIS OF NATIONWIDE THAI LYMPHOMA STUDY GROUP

PS1077

Wudhikarn, K.1; Bunworasate, U.1; Julamanee, J.2; Lekhakula, A.3; Ekwattanakit, S.4; Khuhapinant, A.4; Norasetthada, L.5; Nawarawong, W.5; Laoruangroj, C.6; Numbenjapon, T.6; Niparuck, P.7; Chancharunee, S.7; Kanitsap, N.8; Wongkhatee, S.9; Makruasi, N.10; Wong, P.11; Sirijerachai, C.12; Chansung, K.12; Suwanban, T.13; Praditsuktavorn, P.14; Intragumtornchai, T.1

doi: 10.1097/01.HS9.0000562600.01604.ae
Poster Session II: Aggressive non-Hodgkin lymphoma - Clinical
Free

1Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok

2Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand

3Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla

4Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok

5Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai

6Medicine, Faculty of Medicine, Phramongkutklao Hospital and College of Medicine

7Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University

8Medicine, Faculty of Medicine, Thamasat University, Bangkok

9Medicine, Khon Kaen Regional Hospital, Khon Kaen

10Medicine, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok

11Medicine, Faculty of Medicine, Naresuan University, Phitsanulok

12Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen

13Medicine, Rajavithi hospital

14Medicine, Chulabhorn Hospital, Bangkok, Thailand

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Background:

Peripheral T cell lymphoma (PTCL) is relatively uncommon compared to B cell lymphoma (B-NHL), however, it generally carries worse prognosis. Treatment failure and early relapse are major dilemma of PTCLs. Identification of high-risk patients using various tools may better refine long-term prognosis of PTCL patients. There were data indicating event free survival (EFS) at 12 months (EFS12) and 24 months (EFS24) as strong surrogate predictors for disease-related outcomes in many B-NHL. However, the implication of such surrogate end-points has been limited in PTCLs. Herein, we explored EFS12 and EFS24 as tools to stratify survival outcome in PTCL patients.

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Aims:

To EFS12 or EFS24 as a tool to stratify survival outcome in PTCL.

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Methods:

Thai Lymphoma Study Group is the nationwide collaborative effort composing of 13 major medical centers in Thailand. The registry prospectively enrolled newly diagnosed lymphoma patients between 2006 and 2014. Here, we focused on systemic PTCL treated with chemotherapy and had adequate follow-up data. EFS was defined as time between primary treatment to relapse, re-treatment, or death from any causes. EFS12 and EFS24 were binary endpoints defined as whether developing events at 12 and 24 months after treatment initiation. Overall survival (OS) was defined as time from a specific timepoints either diagnosis or EFS12 to death. Logistic regression model was used to evaluate associations between clinical characteristics and EFS12/EFS24. Cox regression with EFS12/EFS24 as a time-dependent covariate was applied to evaluate the association between EFS12 and OS.

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Results:

There were 353 systemic PTCL in our cohort. A total of 292 (83%) patients received multiagent chemotherapy. Median age at diagnosis was 49 years (IQR 36-60 years). Median EFS and OS of patients who received treatment were 16.3 and 27.7 months (CI 95% 12.6-28.3 and 18.8-50.4 months respectively). A total of 138 patients (47.1%) developed an event within 12 months after treatment initiation (failed to achieve EFS12). Patients who failed to achieve EFS12 had higher proportion of impaired performance status, high IPI, and presence of B symptoms (Figure 1). After a median follow-up of 53.7 months, Patients who achieved EFS12 had superior OS compared to patients who failed to achieve EFS12 (5-years OS after treatment initiation 70.5% vs 12%, HR 7.03, 95%CI 5.07-9.74, p < 0.001). Landmark analysis confirmed the association between EFS12 and OS after 12 months timepoint (5-years OS after EFS12 67.5% vs 11.5%, HR 6.45, 95%CI 4.65-8.96, p < 0.001). Similar results were seen with patients who achieved EFS24 for both survival after treatment initiation and after 24 months timepoint (Figure 1).

Figure

Figure

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Summary/Conclusion:

EFS12 and EFS24 are strong surrogate endpoints for treatment outcomes in PTCL patients.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health Inc., on behalf of the European Hematology Association.