Insights into the Epidemiology, Survival, and Prognostic Factors of T-Lymphoblastic Lymphoma in a Multicenter Retrospective Study: Evaluation of Chidamide as a Promising Therapeutic Avenue

Abstract

Abstract Objective The primary objective of this retrospective multicenter study was to elucidate the epidemiological characteristics, survival outcomes and prognostic factors of T-cell lymphoblastic lymphoma (T-LBL) patients in real-world settings. Furthermore, a secondary aim was to comprehensively evaluate the clinical management strategies, and therapeutic effectiveness of the combination therapy involving Chidamide and chemotherapy. Methods The study analyzed a cohort of 118 newly diagnosed T-LBL patients from multiple clinical centers between 2009 and 2022, among whom 17 patients received Chidamide. A comprehensive assessment of patient demographics, treatment schedules, treatment response, prognostic indicators, and prognostic factors was conducted. Results The 5-year progression-free survival (PFS) and overall survival (OS) rates for the entire cohort were 44.4% and 50.4%. The combination therapy of Chidamide and chemotherapy demonstrated promising outcomes, yielding an 88.2% overall response rate (ORR) and a 70.6% complete remission rate (CRR), indicating its effectiveness and safety for T-LBL treatment. The median PFS and the median OS were considerably longer in the Chidamide group (123.7 months and NE) than the reference group. In addition, the study revealed that peripheral blood neutrophil-to-lymphocyte ratio (NLR) ≥ 4.07 was an independent prognostic factor negatively impacting patients' PFS and OS, with risk ratios of 3.26 (95% CI 1.79–5.95, p < 0.001) and 3.78 (95% CI 1.95–7.30, p < 0.001). Conclusion This retrospective multicenter analysis provides compelling evidence that Chidamide, used in conjunction with chemotherapy, is an efficacious treatment modality for T-LBL. Moreover, peripheral blood NLR serves as a valuable independent prognostic factor for predicting T-LBL patient outcomes.