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Messéant O, Drieux F, Sako N, Fataccioli V, Camus V, Robe C, Houot R, Tas P, Llamas-Gutierrez F, Lamaison C, Abraham J, Delage-Corre M, Benguerfi S, Bossard JB, Gaulard P, Lemonnier F. Clinical and histological study of follicular helper T-cell lymphomas with indolent evolution. Eur J Cancer 2024; 197:113479. [PMID: 38128263 DOI: 10.1016/j.ejca.2023.113479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Follicular helper T-cell lymphomas (TFHL) have an aggressive course with a poor outcome. European and US guidelines recommend anthracycline-based chemotherapy as a first-line treatment, but the 5-year overall survival rate is still approximately 30%. We describe here the features of a cohort of TFHL patients who experienced prolonged survival despite the absence of specific treatment or the initiation of steroid-based therapy. PATIENTS AND METHODS In our study, we describe 15 adult patients who suffered from TFHL and had not received intensive chemotherapy at diagnosis for any reason. Biopsies of these cases were centrally reviewed, and the mutational pattern was determined using next-generation sequencing. RESULTS These 15 patients had the classic clinical, biological and pathological features of TFHL, angioimmunoblastic-type. TET2 mutations were found in 83% of patients; RHOA G17V, IDH2 R172 and DNMT3A mutations were found in 67%, 42% and 33% of the patients, respectively. Among the 15 patients, 8 did not receive any treatment, and 7 received steroid-based treatment. Ten patients had progression (5 in each group). Four patients died (3 of them from the progression of their lymphoma). The median follow-up in our cohort was 53 months. The 5-year OS was 66%, 100% for untreated patients and 29% for the others. In those 2 groups, the median time to treatment initiation was 22 months from diagnosis. CONCLUSION We described a series of 15 well-characterized TFHL patients with an indolent outcome, suggesting that a watch-and-wait approach can be proposed in selected patients. Identifying factors predicting such evolution is warranted.
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Affiliation(s)
- Ondine Messéant
- Department of Hematology, University Hospital of Pontchaillou, Rennes, France.
| | - Fanny Drieux
- INSERM U1245, University Hospital of Henri Becquerel, Rouen, France; Department of Pathology, University Hospital of Henri Becquerel, Rouen, France
| | - Nouhoum Sako
- Department of Pathology, University Hospital of Henri Mondor, AP-HP, Créteil, France; INSERM U955, Mondor Biomedical Research Institute, Créteil, France
| | - Virginie Fataccioli
- Department of Pathology, University Hospital of Henri Mondor, AP-HP, Créteil, France; INSERM U955, Mondor Biomedical Research Institute, Créteil, France
| | - Vincent Camus
- Department of Hematology, University Hospital of Henri Becquerel, Rouen, France
| | - Cyrielle Robe
- Department of Pathology, University Hospital of Henri Mondor, AP-HP, Créteil, France; INSERM U955, Mondor Biomedical Research Institute, Créteil, France
| | - Roch Houot
- Department of Hematology, University Hospital of Pontchaillou, Rennes, France
| | - Patrick Tas
- Department of Pathology, University Hospital of Pontchaillou, Rennes, France
| | | | - Claire Lamaison
- Department of Pathology, University Hospital of Pontchaillou, Rennes, France
| | - Julie Abraham
- Department of Hematology, University Hospital of Dupuytren, Limoges, France
| | | | - Soraya Benguerfi
- Department of Infectious Diseases and Medical Intensive Care, University Hospital of Pontchaillou, Rennes, France
| | | | - Philippe Gaulard
- Department of Pathology, University Hospital of Henri Mondor, AP-HP, Créteil, France; INSERM U955, Mondor Biomedical Research Institute, Créteil, France; Paris-East, Créteil University, Créteil, France
| | - François Lemonnier
- INSERM U955, Mondor Biomedical Research Institute, Créteil, France; Paris-East, Créteil University, Créteil, France; Department of Lymphoid Malignancies, University Hospital of Henri Mondor, AP-HP, Créteil, France
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