How we are successful in therapy of t‐cell lymphoma patients (≥70 years). real‐wordl analysis from the czech lymphoma study group registry (nihil).

Background: T-cell lymphomas (TCL) belong to the malignancies with poor prognosis. Up to now, the core of treatment is based on chemotherapy. The best results are reached with intensive regimen (etoposide-based; CHOEP) and autologous stem cell transplantation (autoTx). In the patients ≥70 years is not usually possible to apply this strategy. Methods: In total 1 432 patients (pts) with newly diagnosed T-cell lymphomas (1999–2020) was enrolled in NIHIL database (Clinical Trial gov. NCT03199066), 503 patients with a diagnosis other than PTCL, AITL and ALCL, and 23 patients with no follow-up information were excluded. We selected 240 patients ≥70 years at lymphoma diagnosis with the ALCL, PTCL-NOS and AITL/TFH-TCL (around 67% patients). Results: In the cohort of 240 patients ≥70 years, PTCL-NOS (131/240; 54.6%) was the most frequent, followed by ALCL (61/240; 25.4%) and AITL (48/240; 20%). Median age was 75 yrs (range; 70-95), 131/240 (54.6%) were men, ECOG >2 had 45/240 (19.3%) pts, advanced disease (stage III or IV) was in 180/240 (76.2%) pts, and 161/240 (68.8%) pts had LDH above normal range. First-line therapy received 233/240 (97.1%) patients, systemic chemotherapy was administered in 201/240 (83.8%), the most frequent regimen was CHOP in 114/201 (56.7%), COP in 15%, etoposide-based regimens were administered in 6.5% patients only; no patients received alloTx or autoTx, monoclonal antibody (brentuximab vedotin, alemtuzumab, rituximab) was given in 11/201 (5.5%) cases. Best response after first-line treatment included 83 (34.6%) CR/Cru, 32 (13.3%) PR, 10 (4.2%) SD and 37 (15.4%) PD, but there were 58 (24.2%) pts with not evaluable and 20 (8.3%) pts with unknown response. Median OS (95% CI) was 1.2 yrs (0.9–1.5), and median PFS 0.8 yrs (0.7–1.0). From the subgroup of 78 patients with unknown/unevaluable response, 94.6% died with median 0.32 yrs (range; 0.14-5.6). Conclusion: TCL of elderly ≥70yrs represents difficult subgroup of patients with increasing proportion of prognostically worse subtypes (PTCL-NOS, AITL). Despite chemotherapy is administered in majority of cases, the response is reached in half of them only, but around another third of patients died early during or immediately after therapy. Keyword: Aggressive T-cell non-Hodgkin lymphoma Conflicts of interests pertinent to the abstract D. Belada Consultant or advisory role Gilead, Roche, Novartis, Takeda Educational grants: Roche, Gilead Sciences H. Mocikova Consultant or advisory role Takeda, Roche, Astra Seneca, Janssen, Abbvie Educational grants: Janssen, Takeda J. Duras Consultant or advisory role Roche, Takeda, Celgene