Real-World Data on Clinical Outcomes and Validation of Prognostic Models for Angioimmunoblastic T-cell Lymphoma: A Multicentric Retrospective Study in Southern China

Background: This study aimed to elucidate the treatment outcomes and prognosis of angioimmunoblastic T-cell lymphoma (AITL) patients in a real-world setting. Objectives: We assessed the clinical value of new drug applications, evaluated the predictive power of various prognostic models, and provided valuable insights to guide future research endeavors. Methods: We retrospectively analyzed 140 patients with AITL enrolled in 19 lymphoma centers of the T-cell Lymphoma Collaborative Group in South China. In this study, 82.9% of patients were treated with a CHOP-like chemotherapy regimen as the primary intervention. An initial treatment strategy incorporating Chidamide was employed for 36.4% of the patient cohort. Multivariate analyses were performed using the Cox proportional hazard regression model. The concordance index (C-index) was utilized to assess and compare the predictive power of the prognostic models. Results: The median age of the 140 patients was 62.0 years. The 2-year progression-free survival (PFS) rate was 36.1%, and the 2-year overall survival (OS) rate was 60.3%. Among the first-line treatments, the CR rates for the chidamide-containing and chidamide-free groups were 21.6% and 28.1%, respectively. Univariate analysis identified age, bone marrow involvement, and not receiving a CHOP-like regimen as first-line treatment as poor prognostic factors for both PFS and OS. Multivariate analysis showed that age was the most significant independent prognostic factor. The AITL score, PIAI score and Chinese AITL score showed higher C-index values, the Chinese AITL score demonstrating the most distinct stratification between the low-risk and high-risk groups. Conclusions: The prognosis of AITL remains poor in the real world. The addition of the HDAC inhibitor chidamide did not increase the remission rate or prolong the remission. The Chinese AITL score was the most powerful model for risk stratification and predicting long-term prognosis in Chinese AITL patients.