Real-world data on long-term outcomes in patients with T-cell lymphomas: a nationwide study of Korea

Abstract Background Peripheral T-cell lymphomas (PTCLs) are a rare and heterogeneous group of aggressive malignancies. This study aimed to comprehensively analyze patients diagnosed with PTCLs in Korea, evaluating treatment outcomes, including transplantation and long-term survival. Patients and methods In this retrospective study, clinical data from the National Health Insurance Service on patients with PTCL were investigated. Most patients diagnosed with mature T-cell lymphomas and natural killer (NK)/T-cell lymphomas between January 2005 and December 2022 in Korea were included. Incidence rates of each subtype and survival outcomes of both treated and untreated patients were analyzed. Results A total of 12,573 patients were analyzed. PTCL not otherwise specified (PTCL-NOS) and extranodal NK/T-cell lymphoma were the most frequently diagnosed, followed by angioimmunoblastic T-cell lymphoma (AITL). Compared to the general population, the relative survival rate was highest in anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma. With a median follow-up of 6.7 years, the 3-year and 5-year progression-free survival (PFS) rates among treated patients were 44.0% and 39.5%, while the overall survival (OS) rates were 48.6% and 43.5%, respectively. Kaplan–Meier survival curves indicated that patients who added etoposide to the CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen showed improved PFS and OS. In addition, autologous stem cell transplantation significantly improved PFS and OS, particularly in the PTCL-NOS and AITL subtypes. Conclusion Patients who received etoposide-containing CHOP-based regimens had improved treatment outcomes. The survival benefits of consolidative autologous stem cell transplantation (auto-SCT) were evident in PTCL-NOS and AITL.