Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States.
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.
['Hsi|Eric D|ED|', 'Horwitz|Steven M|SM|', 'Carson|Kenneth R|KR|', 'Pinter-Brown|Lauren C|LC|', 'Rosen|Steven T|ST|', 'Pro|Barbara|B|', 'Federico|Massimo|M|', 'Gisselbrecht|Christian|C|', 'Schwartz|Marc|M|', 'Bellm|Lisa A|LA|', 'Acosta|Mark|M|', 'Collie|Angela M|AM|', 'Gruver|Aaron M|AM|', 'Grzywacz|Bartosz J|BJ|', 'Turakhia|Samir|S|', 'Shustov|Andrei R|AR|', 'Advani|Ranjana H|RH|', 'Feldman|Tatyana|T|', 'Lechowicz|Mary Jo|MJ|', 'Smith|Sonali M|SM|', 'Lansigan|Frederick|F|', 'Tulpule|Anil|A|', 'Craig|Michael D|MD|', 'Greer|John P|JP|', 'Kahl|Brad S|BS|', 'Leach|Joseph W|JW|', 'Morganstein|Neil|N|', 'Casulo|Carla|C|', 'Park|Steven I|SI|', 'Foss|Francine M|FM|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D014408:Biomarkers, Tumor D054382:Chemokine CXCL13 D005260:Female D006801:Humans D007119:Immunoblastic Lymphadenopathy D017728:Lymphoma, Large-Cell, Anaplastic D016411:Lymphoma, T-Cell, Peripheral D008297:Male D008875:Middle Aged D011446:Prospective Studies D014481:United States D055815:Young Adult
Diagnosis Practice Biomarkers Histopathologic type Prospective studies