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A new prognostic score comprising lactate dehydrogenase, albumin and neutrophil to lymphocyte ratio to predict sensitivity to first-line chemotherapy in patients with peripheral T-cell lymphomas

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Abstract

No standard therapy for peripheral T-cell lymphomas (PTCLs) has been established, and treatment outcomes are poor. Upfront stem cell transplantation has been investigated in several studies, some of which have reported promising outcomes. However, some patients maintain long-term remission after chemotherapy alone. It is thus important to predict sensitivity to first-line chemotherapy to optimize treatment strategies. In the present study, we retrospectively analyzed time to treatment failure (TTF) of first-line chemotherapy in 59 patients with PTCLs. On multivariate analysis for TTF, elevated lactate dehydrogenase level, hypoalbuminemia, and high neutrophil-to-lymphocyte ratio were significant prognostic factors. Using these three factors, we also developed a new model that effectively distinguished patient outcomes. The TTF rate at 1 year from diagnosis was 71.4% in patients with score 0 (0 factor), 31.8% with score 1 (1 factor) and 4.5% with score 2 (2–3 factors) (P < 0.001). The prognostic power was superior to that of the Prognostic Index for PTCL-unspecified score. Patients with scores of 1 and 2 had poor TTF, and may be candidates for upfront stem cell transplantation if they respond to first-line chemotherapy. Further investigation in a larger cohort is warranted to determine the general applicability of this score.

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Acknowledgements

We would like to thank all the patients who took part in this study.

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Authors and Affiliations

  1. Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Satoshi Kaito, Yusuke Kanemasa, Toshihiro Okuya, Tsukasa Yamaguchi, Chikako Funasaka, Tatsu Shimoyama, Yasushi Omuro & Yoshiharu Maeda

  2. Department of Clinical Research Support, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Yuki Sasaki

  3. Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

    Tsunekazu Hishima

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  1. Satoshi Kaito
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  2. Yusuke Kanemasa
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Correspondence to Satoshi Kaito.

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Kaito, S., Kanemasa, Y., Sasaki, Y. et al. A new prognostic score comprising lactate dehydrogenase, albumin and neutrophil to lymphocyte ratio to predict sensitivity to first-line chemotherapy in patients with peripheral T-cell lymphomas. Int J Hematol 107, 451–459 (2018). https://doi.org/10.1007/s12185-017-2362-6

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  • DOI: https://doi.org/10.1007/s12185-017-2362-6

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