Peripheral T-Cell Lymphomas in Southern Taiwan: Epidemiology, Treatment Patterns, and Long-Term Outcomes

Peripheral T-cell lymphomas (PTCLs) are heterogeneous neoplasms with poor prognosis and marked geographic variation. Data from Taiwan remain limited. We conducted a 15-year retrospective cohort study of 249 patients diagnosed with PTCL at two major centers in southern Taiwan between 2010 and 2024 to characterize regional epidemiology, real-world treatment patterns, and survival outcomes. The cohort demonstrated subtype distribution typical of East Asia, with nodal T follicular helper cell lymphoma, angioimmunoblastic type (22%), extranodal NK/T-cell lymphoma (21%), and PTCL-NOS (15%) predominating. Most patients presented with high-risk features: 71% Stage III-IV disease, 47% bone marrow involvement, and 64% elevated LDH. Median overall survival was 17.6 months, and event-free survival was 6.4 months. Multivariable analysis identified ECOG performance status ≥ 2, elevated LDH, > 1 extranodal site, and age ≥ 60 years as four independent adverse prognostic factors. Frontline hematopoietic stem cell transplantation (HSCT) showed no significant improvement in outcomes; however, salvage chemotherapy followed by HSCT provided prolonged survival after relapse, with median survival after relapse not reached, compared with 6.1 months with salvage chemotherapy alone. These findings underscore PTCL's persistently poor outcomes and the essential role of salvage HSCT in durable survival. Addressing biological complexity and improving therapeutic strategies remain critical for advancing care. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.