Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States

Eric D. Hsi, Steven M. Horwitz, Kenneth R. Carson, Lauren C. Pinter-Brown, Steven T. Rosen, Barbara Pro, Massimo Federico, Christian Gisselbrecht, Marc Schwartz, Lisa A. Bellm, Mark Acosta, Angela M. Collie, Aaron M. Gruver, Bartosz J. Grzywacz, Samir Turakhia, Andrei R. Shustov, Ranjana H. Advani, Tatyana Feldman, Mary Jo Lechowicz, Sonali M. Smith & 10 others Frederick Lansigan, Anil Tulpule, Michael D. Craig, John P. Greer, Brad S. Kahl, Joseph W. Leach, Neil Morganstein, Carla Casulo, Steven I. Park, Francine M. Foss

Research output: Contribution to journalArticle

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Abstract

With increased understanding of the unique entities of peripheral T-cell lymphoma (PTCL), subtype-specific approaches are emerging, and more precise diagnoses are becoming increasingly important. Using data from a large prospective cohort study, we examined the diagnostic patterns of PTCL in the United States. We found that the workup for PTCL varies widely and often lacks important phenotypic information to fully characterize the lymphoma. 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.

Original languageEnglish (US)
Pages (from-to)193-200
Number of pages8
JournalClinical Lymphoma, Myeloma and Leukemia
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2017

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Peripheral T-Cell Lymphoma
T-Cell Lymphoma
Anaplastic Large-Cell Lymphoma
Lymphoma
Cohort Studies
Prospective Studies
Helper-Inducer T-Lymphocytes

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Hsi, E. D., Horwitz, S. M., Carson, K. R., Pinter-Brown, L. C., Rosen, S. T., Pro, B., ... Foss, F. M. (2017). Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States. Clinical Lymphoma, Myeloma and Leukemia, 17(4), 193-200. https://doi.org/10.1016/j.clml.2016.10.001
Hsi, Eric D. ; Horwitz, Steven M. ; Carson, Kenneth R. ; Pinter-Brown, Lauren C. ; Rosen, Steven T. ; Pro, Barbara ; Federico, Massimo ; Gisselbrecht, Christian ; Schwartz, Marc ; Bellm, Lisa A. ; Acosta, Mark ; Collie, Angela M. ; Gruver, Aaron M. ; Grzywacz, Bartosz J. ; Turakhia, Samir ; Shustov, Andrei R. ; Advani, Ranjana H. ; Feldman, Tatyana ; Lechowicz, Mary Jo ; Smith, Sonali M. ; Lansigan, Frederick ; Tulpule, Anil ; Craig, Michael D. ; Greer, John P. ; Kahl, Brad S. ; Leach, Joseph W. ; Morganstein, Neil ; Casulo, Carla ; Park, Steven I. ; Foss, Francine M. / Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States. In: Clinical Lymphoma, Myeloma and Leukemia. 2017 ; Vol. 17, No. 4. pp. 193-200.
@article{5c9fb4c003f140d59232796d4561340d,
title = "Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States",
abstract = "With increased understanding of the unique entities of peripheral T-cell lymphoma (PTCL), subtype-specific approaches are emerging, and more precise diagnoses are becoming increasingly important. Using data from a large prospective cohort study, we examined the diagnostic patterns of PTCL in the United States. We found that the workup for PTCL varies widely and often lacks important phenotypic information to fully characterize the lymphoma. 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.",
author = "Hsi, {Eric D.} and Horwitz, {Steven M.} and Carson, {Kenneth R.} and Pinter-Brown, {Lauren C.} and Rosen, {Steven T.} and Barbara Pro and Massimo Federico and Christian Gisselbrecht and Marc Schwartz and Bellm, {Lisa A.} and Mark Acosta and Collie, {Angela M.} and Gruver, {Aaron M.} and Grzywacz, {Bartosz J.} and Samir Turakhia and Shustov, {Andrei R.} and Advani, {Ranjana H.} and Tatyana Feldman and Lechowicz, {Mary Jo} and Smith, {Sonali M.} and Frederick Lansigan and Anil Tulpule and Craig, {Michael D.} and Greer, {John P.} and Kahl, {Brad S.} and Leach, {Joseph W.} and Neil Morganstein and Carla Casulo and Park, {Steven I.} and Foss, {Francine M.}",
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doi = "10.1016/j.clml.2016.10.001",
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pages = "193--200",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
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Hsi, ED, Horwitz, SM, Carson, KR, Pinter-Brown, LC, Rosen, ST, Pro, B, Federico, M, Gisselbrecht, C, Schwartz, M, Bellm, LA, Acosta, M, Collie, AM, Gruver, AM, Grzywacz, BJ, Turakhia, S, Shustov, AR, Advani, RH, Feldman, T, Lechowicz, MJ, Smith, SM, Lansigan, F, Tulpule, A, Craig, MD, Greer, JP, Kahl, BS, Leach, JW, Morganstein, N, Casulo, C, Park, SI & Foss, FM 2017, 'Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States', Clinical Lymphoma, Myeloma and Leukemia, vol. 17, no. 4, pp. 193-200. https://doi.org/10.1016/j.clml.2016.10.001

Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States. / Hsi, Eric D.; Horwitz, Steven M.; Carson, Kenneth R.; Pinter-Brown, Lauren C.; Rosen, Steven T.; Pro, Barbara; Federico, Massimo; Gisselbrecht, Christian; Schwartz, Marc; Bellm, Lisa A.; Acosta, Mark; Collie, Angela M.; Gruver, Aaron M.; Grzywacz, Bartosz J.; Turakhia, Samir; Shustov, Andrei R.; Advani, Ranjana H.; Feldman, Tatyana; Lechowicz, Mary Jo; Smith, Sonali M.; Lansigan, Frederick; Tulpule, Anil; Craig, Michael D.; Greer, John P.; Kahl, Brad S.; Leach, Joseph W.; Morganstein, Neil; Casulo, Carla; Park, Steven I.; Foss, Francine M.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 17, No. 4, 01.04.2017, p. 193-200.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of Peripheral T-cell Lymphoma Diagnostic Workup in the United States

AU - Hsi, Eric D.

AU - Horwitz, Steven M.

AU - Carson, Kenneth R.

AU - Pinter-Brown, Lauren C.

AU - Rosen, Steven T.

AU - Pro, Barbara

AU - Federico, Massimo

AU - Gisselbrecht, Christian

AU - Schwartz, Marc

AU - Bellm, Lisa A.

AU - Acosta, Mark

AU - Collie, Angela M.

AU - Gruver, Aaron M.

AU - Grzywacz, Bartosz J.

AU - Turakhia, Samir

AU - Shustov, Andrei R.

AU - Advani, Ranjana H.

AU - Feldman, Tatyana

AU - Lechowicz, Mary Jo

AU - Smith, Sonali M.

AU - Lansigan, Frederick

AU - Tulpule, Anil

AU - Craig, Michael D.

AU - Greer, John P.

AU - Kahl, Brad S.

AU - Leach, Joseph W.

AU - Morganstein, Neil

AU - Casulo, Carla

AU - Park, Steven I.

AU - Foss, Francine M.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - With increased understanding of the unique entities of peripheral T-cell lymphoma (PTCL), subtype-specific approaches are emerging, and more precise diagnoses are becoming increasingly important. Using data from a large prospective cohort study, we examined the diagnostic patterns of PTCL in the United States. We found that the workup for PTCL varies widely and often lacks important phenotypic information to fully characterize the lymphoma. 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.

AB - With increased understanding of the unique entities of peripheral T-cell lymphoma (PTCL), subtype-specific approaches are emerging, and more precise diagnoses are becoming increasingly important. Using data from a large prospective cohort study, we examined the diagnostic patterns of PTCL in the United States. We found that the workup for PTCL varies widely and often lacks important phenotypic information to fully characterize the lymphoma. 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.

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U2 - 10.1016/j.clml.2016.10.001

DO - 10.1016/j.clml.2016.10.001

M3 - Article

VL - 17

SP - 193

EP - 200

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2650

IS - 4

ER -