Clinicopathological Characteristics and Prognostic Factors in Angioimmunoblastic T-cell Lymphoma: a Retrospective...

Our study aimed to analyze the molecular and clinical characteristics of angioimmunoblastic T-cell lymphoma (AITL), identify prognostic factors, and evaluate their implications for patient outcomes.

This retrospective study analyzed 33 patients diagnosed with AITL between 2012 and 2022 at our center. Clinical data, laboratory parameters, pathological findings, and treatment outcomes were evaluated. Survival analyses were performed using the Kaplan-Meier method, and prognostic factors were identified through univariate Cox regression analysis.

The median age was 64.1 ± 7.2 years, with male predominance (63.6%). Most patients presented with advanced disease (69.7% stage IV). Immunophenotypic analysis confirmed high expression of follicular helper T-cell markers, including PD-1 (96.9%), CXCL13 (83.3%), and BCL-6 (96.6%). EBV was detected in 72.7% of specimens by EBER-ISH and 90% by EBV-DNA PCR. Univariate analysis identified lower hemoglobin, decreased platelet counts, low albumin levels, and elevated β2-microglobulin as significant negative prognostic factors for progression-free survival (PFS). For overall survival (OS), low albumin levels (HR 0.8, 95% CI 0.69 - 0.92, p = 0.002) and elevated β2-microglobulin (HR 1.32, 95% CI 1.03 - 1.69, p = 0.029) were significant predictors of inferior outcomes. Interestingly, PD-1 positivity was associated with significantly better PFS (HR 0.03, 95% CI 0 - 0.52, p = 0.016).

This study highlights the aggressive nature of AITL and identifies several readily accessible laboratory parameters as important prognostic factors. The protective effect of PD-1 positivity on survival outcomes warrants further investigation. While CHOP/CHOPE remains the standard treatment, the addition of novel targeted therapies shows promise for improving patient outcomes in this challenging lymphoma subtype.