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Hu G, Song Z, Lv C, Sun Y, Zhang Y, Liu X, Han X, Li L, Qiu L, Qian Z, Zhou S, Gong W, Meng B, He J, Wang X, Zhang H. Clinical Features and Outcomes of Primary Cutaneous Peripheral T-Cell Lymphoma, Not Otherwise Specified, Treated with CHOP-Based Regimens. Cancers (Basel) 2025; 17:1673. [PMID: 40427170 PMCID: PMC12109765 DOI: 10.3390/cancers17101673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2025] [Revised: 05/12/2025] [Accepted: 05/13/2025] [Indexed: 05/29/2025] Open
Abstract
Background: Primary cutaneous peripheral T-cell lymphoma, not otherwise specified (pcPTCL-NOS), is a rare and aggressive form of lymphoma. Its characteristics and treatment outcomes remain poorly understood. Methods: We identified 15 patients who were diagnosed with pcPTCL-NOS between January 2014 and August 2024 at Tianjin Medical University Cancer Institute and Hospital (TMUCIH) in this retrospective study. The clinical and immunophenotypic features, treatment regimens, and outcomes of these patients were investigated. Results: All patients (4 men, 11 women; median age 54 years) presented with skin lesions, including five stage T1, four stage T2 and six stage T3 lesions. pcPTCL-NOS manifests clinically either with solitary or disseminated rapidly growing nodules/tumors and papules and, less often, ulcers. The lesion sites in patients presenting with solitary/localized tumors (stage T1 and T2) were the head and limbs, and those in patients presenting with disseminated lesions (stage T3) were the trunk, head, and limbs. The CD4/CD8 immunophenotypic characteristics were as follows: CD4+/CD8- 53.33%; CD4+/CD8+ 26.67%; CD4-/CD8- 13.33%; and CD4-/CD8+ 6.67%. One patient had a T follicular helper (TFH) phenotype. Five patients had aberrant expression of the B-cell marker CD20 by tumor cells. All patients received CHOP or CHOP-like regimens as the initial treatment, with three patients undergoing complete lesion resection before chemotherapy, seven patients receiving treatment combined with chidamide (tucidinostat), two patients receiving treatment combined with brentuximab vedotin, two patients receiving treatment combined with mitoxantrone liposomes (Lipo-Mit), three patients receiving treatment combined with radiotherapy, and two patients receiving ASCT after the first-line treatment. The OS rates at 1 year, 2 years, and 3 years were 80%, 77.8%, and 77.8%, respectively; the PFS rates were 60%, 44.4%, and 33.3%, respectively. With a median follow-up of 40 months, the median PFS was 21 months, and the median OS was not reached. Univariate analyses revealed that patients with B symptoms and the CD4-/CD8- phenotype had inferior outcomes (p < 0.05). Age, sex, tumor stage, PIT score, Ki-67 index, elevated β2-MG levels, expression of CD20 or PD1, and treatment selection were not associated with the prognosis. A trend of a survival benefit in patients with solitary (T1) tumors compared with patients with disseminated (T2, T3) tumors was observed, suggesting that it is possible to reduce the intensity of treatment in patients with T1 tumors in the future. Conclusions: pcPTCL-NOS is an aggressive but poorly characterized lymphoma that may require early and active systemic treatment. However, for patients with T1 tumors, reducing the intensity of treatment with CHOP should be appropriately considered.
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Affiliation(s)
- Ge Hu
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Zheng Song
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Chao Lv
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Yifei Sun
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Yidan Zhang
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Xia Liu
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Xue Han
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Lanfang Li
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Lihua Qiu
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Zhengzi Qian
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Shiyong Zhou
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Wenchen Gong
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China; (W.G.); (B.M.)
| | - Bin Meng
- Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China; (W.G.); (B.M.)
| | - Jin He
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Xianhuo Wang
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
| | - Huilai Zhang
- State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine/Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, The Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China; (G.H.); (Z.S.); (C.L.); (Y.S.); (Y.Z.); (X.L.); (X.H.); (L.L.); (L.Q.); (Z.Q.); (S.Z.); (X.W.)
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