The significance of bone marrow involvement in aggressive lymphomas: A retrospective comparison of clinical outcomes between peripheral T cell lymphoma and diffuse large B cell lymphoma in China

Background: Peripheral T cell lymphomas (PTCL) have been demonstrated to have a poorer prognosis than diffuse large B cell lymphoma (DLBCL) due to a high frequency of bone marrow involvement (BMI). However, the clinical characteristics of PTCL with BMI have not been fully described, and the clinical outcomes of PTCL with BMI and DLBCL with BMI have not been well compared. Methods: The clinical characteristics and survival of 25 nodal PTCL cases with BMI and 42 DLBCL cases with BMI were compared. Results: Most of the PTCL patients with BMI had lymphadenopathy (88%), B symptoms (76%), an elevated LDH level (68%), anemia (64%), splenomegaly (60%), and a poor performance status (52%). Except for the differences of lymphadenopathy and thrombocytopenia between PTCL with BMI and DLBCL with BMI, similarities in gender, age, hepatomegaly, splenomegaly, a bulky mass, B symptoms, elevated LDH, ≥2 extranodal sites, ECOG scores ≥2, anemia, and international prognostic index (IPI) and age-adjusted IPI scores were observed between the 2 groups. The 2 groups also had similar 3-year overall survival (25.8 vs. 30.0%, p = 0.846) and progressive-free survival (21.3 vs. 25.2%, p = 0.815) rates. Conclusions: PTCL with BMI have a similar aggressive course and poor survival compared to DLBCL with BMI. Thus, the immunophenotype of either T or B lineage may not be a crucial prognostic indicator of survival for these 2 aggressive lymphomas. Copyright © 2010 S. Karger AG, Basel.