Nationwide Analysis on Incidences and Treatment Outcomes of T-Cell Subtype Lymphomas Based on Health Insurance Review & Assessment Service

Background

The incidence of T-cell lymphomas varies by region worldwide, with a higher occurrence in Far East Asian countries compared to Western countries. There is a lack of recent statistical data on the incidence and clinical outcomes of T-cell lymphomas. The current standard treatment is an anthracycline-containing chemotherapy, but the treatment outcomes indicate that further improvement is needed. Therefore, upfront stem cell transplantation (SCT) is performed for patients who are suitable candidates. The aim of this study is to analyze the incidence and clinical outcomes of T-cell lymphomas in Korea.

Methods

Using data from the Health Insurance Review and Assessment Service of South Korea, we retrospectively analyzed newly diagnosed T-cell lymphomas patients from January 2005 to December 2021. We studied 12,616 patients, 43 patients were excluded from the study due to data error.

Results

A total of 12,573 patients were registered between January 2005 and December 2021. The disease incidence was higher among Koreans in age groups 60-69 (n = 2598, 20.7%) (Figure 1A). Male had a higher incidence (n = 7615, 61%) than female (n = 4958, 39%). Peripheral T-Cell Lymphoma-not otherwise specified (PTCL-NOS) was the most common subtype (n = 3200, 25.5%), followed by Extranodal natural killer (NK)/T- cell lymphoma, nasal type (n = 1671, 13.3%), other mature T/NK-cell lymphoma (n = 1659, 13.2%), mycosis fungoides (n = 1644, 13.1%), angioimmunoblastic T-cell lymphoma (AITL, n = 1483, 11.8%), ALK-positive anaplastic large cell lymphoma (ALCL, n = 396, 3.1%), and ALK-negative ALCL (n = 328, 2.6%) (Figure 1B). CHOP (n = 2859, 56.4%) and CHOEP (n = 577, 11.4%) were used as first-line regimens in PTCL, ALCL and AITL. NK/T cell lymphoma was treated as a first-line therapy with cisplatin plus concurrent radiotherapy (n=389, 7.7%), VIPD(n= 145, 2.8%), VIDL(n= 5, 0.1%) and SMILE (n= 635, 12.5%). Stem cell transplantation was given as a part of front-line therapy (n = 890, 17.5%). Autologous SCT was given to 149 patients (2.9%) and allogeneic SCT was 741 patients (14.6%). The 5-year overall survival (OS) of T-cell lymphomas were 57.8% in patients who received SCT and 42.1% in patients who did not receive SCT (Figure2A). The 5-year OS of PTCL-NOS were 54.2% in patients who received SCT and 30.7% in patients who did not receive SCT. (Figure 2C). Upfront use of combined treatment with chemotherapy and SCT showed better OS than chemotherapy alone in T-cell lymphomas. Patients who received allogeneic SCT had a more favorable progression-free survival.

Conclusions

The incidence was highest in the age group 60-69 years. PTCL-NOS was the most common subtype of T cell lymphomas. Upfront SCT was significantly related to survival benefit.

No relevant conflicts of interest to declare.