Background & objective: The prognosis of relapsed or refractory T-cell non-Hodgkin's lymphoma (T-NHL) is poor. There is no definite prognostic factors and standard regimens for these patients. This study was to explore the prognostic factors and effective regimens for relapsed or refractory T-NHL.
Methods: Clinical records of 45 patients with relapsed or refractory T-NHL, treated in Cancer Center of Sun Yat-sen University from Jan. 1997 to Mar. 2003, were analyzed in terms of response, long-term survival and prognostic factors.
Results: By the end of Jul. 2006, 5 patients still alive; the median follow-up time was 30 (2-70) months. The median survival time after relapse was 22 (2-62) months. Of the 45 patients, 42 (93.3%) received salvage regimen, the response rate was 61.9% (26/42); for those received second-line chemotherapy, the response rate was 52.4% (22/42). The 1-, 3-, and 5-year overall survival rates were 75.6%, 17.8%, and 4.4% for the whole group, 82.1%, 25.0%, and 5.8% for low risk group and 64.7%, 6.5%, and 6.5% for high risk group, respectively (P=0.026). Multivariate analysis showed that serum lactate dehydrogenase (LDH) level (P=0.010), second-line Ann Arbor stage (P=0.009), second-line IPI score (P=0.015), autologous stem cell transplantation (P=0.026), performance status (P=0.002), and IMVP-16 regimen (P=0.026) were independent prognostic factors of relapsed or refractory T-NHL.
Conclusions: Second-line IPI score, autologous stem cell transplantation, and so on, may be independent prognostic factors for relapsed or refractory T-NHL. The prognosis of this disease is poor and the addition of intensive treatments, such as stem cell transplantation, should be considered when alleviated after chemotherapy.