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Clin Lymphoma Myeloma Leuk. 2017 Apr;17(4):193-200. doi: 10.1016/j.clml.2016.10.001. Epub 2017 Jan 10.

Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States.

Author information

1
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH. Electronic address: HSIE@ccf.org.
2
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
3
Department of Medicine, Washington University, St Louis, MO.
4
Department of Medicine, University of California, Los Angeles, Los Angeles, CA.
5
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA.
6
Department of Medicine, Thomas Jefferson University, Philadelphia, PA.
7
Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
8
Department of Hematology-Oncology, Hôpital Saint Louis, Paris, France.
9
MedNet Solutions, Minnetonka, MN.
10
Research and Development, Spectrum Pharmaceuticals, Inc, Irvine, CA.
11
Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH.
12
Department of Medicine, Fred Hutchinson Cancer Research Center, Seattle, WA.
13
Department of Medicine, Stanford University Medical Center, Stanford, CA.
14
Department of Hematology/Oncology, Hackensack University Medical Center, Hackensack, NJ.
15
Department of Hematology and Oncology, Emory University, Atlanta, GA.
16
Department of Medicine, University of Chicago, Chicago, IL.
17
Department of Medicine, Dartmouth Hitchcock Medical Center, Hanover, NH.
18
Department of Medicine, University of Southern California, Los Angeles, CA.
19
Department of Medicine, West Virginia University, Morgantown, WV.
20
Department of Hematology, Vanderbilt University, Nashville, TN.
21
Department of Medicine, University of Wisconsin, Madison, WI.
22
Minnesota Oncology, Virginia Piper Cancer Institute, Minneapolis, MN.
23
Overlook Medical Center, Summit, NJ.
24
Department of Medicine, University of Rochester, Rochester, NY.
25
Department of Internal Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.
26
Department of Medical Oncology, Yale University, New Haven, CT.

Abstract

BACKGROUND:

With increased understanding of the unique entities, subtype-specific approaches for peripheral T-cell lymphoma (PTCL) are emerging, and more precise diagnoses are becoming increasingly important. PATIENTS AND METHODS: We analyzed the approach to the histopathologic diagnosis of PTCL using data from the comprehensive oncology measures of peripheral T-cell lymphoma (COMPLETE) study. The COMPLETE trial is a large prospective cohort study of patients with newly diagnosed PTCL in the United States.

RESULTS:

A total of 499 patients were enrolled from 40 academic and 15 community-based centers. Baseline assessment forms were collected for 493 patients, of which 435 (88%) were available for analysis. The most common diagnoses were PTCL, not otherwise specified (PTCL-NOS), anaplastic large cell lymphoma, and angioimmunoblastic T-cell lymphoma (AITL). A mean of 10 markers (range, 0-21) was assessed per patient. CD30 was assessed frequently but not uniformly in cases that were not anaplastic large cell lymphoma. Only 17% of PTCL-NOS cases were assessed for PD1. CXCL13 was a relatively sensitive marker in AITL, expressed in 84% of tested cases; however, only 3% of PTCL-NOS cases were tested. T follicular helper cell marker assessment differed between academic and community practices, with PD1 more often evaluated by academic centers in cases of AITL (62% vs. 12%; P = .01).

CONCLUSION:

The diagnostic workup for PTCL in the United States varies widely and often lacks important phenotypic information to fully characterize the lymphoma. Gaps in testing of selected markers should be filled, given the impending revision to the World Health Organization classification. The accuracy of diagnosis will become increasingly important as we enter the era of targeted treatment for PTCL.

KEYWORDS:

Biomarkers; Diagnosis; Histopathologic type; Practice; Prospective studies

PMID:
28209473
DOI:
10.1016/j.clml.2016.10.001
[Indexed for MEDLINE]

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