Clinical Pathological Features of Peripheral T Cell Lymphoma with Concurrent Bone Marrow Involvement
American Journal of Clinical and Experimental Medicine
Volume 6, Issue 1, January 2018, Pages: 22-26
Received: Dec. 11, 2017; Accepted: Jan. 10, 2018; Published: Jan. 29, 2018
Views 1720      Downloads 66
Mohamed Masoud, Department of Pathology, Oakland University William Beaumont School of Medicine, Troy, USA
Catherine Xie, Department of Pathology, Oakland University William Beaumont School of Medicine, Troy, USA
Jessica Zhou, Department of Pathology, Oakland University William Beaumont School of Medicine, Troy, USA
Xia Chen, Department of Pathology, Oakland University William Beaumont School of Medicine, Troy, USA
Ming Xie, Department of Pathology, Oakland University William Beaumont School of Medicine, Troy, USA
Article Tools
Follow on us
Peripheral T cell lymphomas (PTCLs) are uncommon and less well studied. Most PTCLs present as systemic disease and often involve bone marrow. Bone marrow involvement by PTCLs may damage the normal hematopoiesis and bring more challenge to clinical management of these patients. This study focuses on the clinical pathological features and clinical outcomes in 13 patients with nodal peripheral T cell lymphoma and subsequent bone marrow biopsy positive for the same lymphoma. Eight patients were diagnosed of peripheral T cell lymphoma - not otherwise specified (PTCL-NOS), 3 angioimmunoblastic T cell lymphoma (AITL), 1 anaplastic large cell lymphoma (ALCL), and 1 T cell lymphoma of gamma-delta origin (TCL-gamma/delta). All patients had peripheral blood abnormalities: 11 anemia, 7 thrombocytopenia, 5 neutropenia, and 2 lymphocytosis. Of interest, the CD4/CD8 phenotype of PTCL was shown correlating with abnormal peripheral blood findings: CD4+/CD8- phenotype was more often associated with anemia and thrombocytopenia, and CD4-/CD8+ phenotype was associated with lymphocytosis. Chemotherapy remains the choice of first line treatment for these patients with or without stem cell transplantation. 12 patients had treatment and follow up data available for review, 5 were in remission or free of disease during the follow up period; 5 patients were alive or in hospice with persistent disease and 2 died of disease due to multiple complications. The outcome of PTCL treated with the standard chemotherapy has been less favorable compared with B cell lymphomas. Majority of the patients with nodal PTCL have bone marrow involvement at the time of initial diagnosis, which has significant impact on normal hematopoiesis and may be a significant factor in the overall unfavorable prognosis for these patients. Further investigation with better knowledge about this disease will be helpful in the development of more efficient therapy and improve the disease free survival and life quality for these patients.
Peripheral T Cell Lymphoma, Bone Marrow Biopsy, Anemia, Thrombocytopenia, Lymphocytosis
To cite this article
Mohamed Masoud, Catherine Xie, Jessica Zhou, Xia Chen, Ming Xie, Clinical Pathological Features of Peripheral T Cell Lymphoma with Concurrent Bone Marrow Involvement, American Journal of Clinical and Experimental Medicine. Vol. 6, No. 1, 2018, pp. 22-26. doi: 10.11648/j.ajcem.20180601.14
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
International T-Cell Lymphoma Project. International Peripheral T-Cell and Natural Killer/T-Cell Lymphoma Study: pathology findings and clinical outcomes. J Clin Oncol. 2008; 26: 4124-4130.
Wang SS and Vose JM. Epidemiology and Prognosis of T-Cell Lymphoma. T-Cell Lymphomas, Contemporary Hematology, 25-39 DOI 10.1007/978-1-62703-170-7_2, © Springer Science+Business Media New York 2013.
Savage KJ. Prognosis and Primary Therapy in Peripheral T-Cell Lymphomas. ASH Hematology, The Education Program 2008: 280-288.
Savage KJ. Aggressive peripheral T-cell lymphomas (specified and unspecified types). Hematology/the Education Program of the American Society of Hematology. 2005; 267-277.
Gallamini A, Stelitano C, Calvi R et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicenter clinical study. Blood. 2004; 103 (7): 474-2479.
Maricer P. Escalon MP, Liu NS, Yang Y, Hess M, Walker PL, Smith TL and Dang NH. Prognostic Factors and Treatment of Patients with T-Cell Non-Hodgkin Lymphoma: The M. D. Anderson Cancer Center Experience. Cancer 2005; 103 (10): 2091-2098.
Chernova NG, Sidorova YV, Ryzhikova NV, Smirnova SY, Julhakyan HL, Sudarikov AB, Vinogradova YE, Kovrigina AM,. Zvonkov EE, Parovichnikova EN and Savchenko VG. Detection of T-Cell Clonality in Bone Marrow in Peripheral T-Cell Lymphoma, Not Otherwise Specified. Blood 2015; 126 (23): 5020.
Savage KJ, Chhanabhai M, Gascoyne RD, Connors JM. Characterization of peripheral T-cell lymphomas in a single North American institution by the WHO classification. Ann Oncol. 2004; 15: 1467-1475.
Zhang Y, Wei Xu W, Liu H and Li J. Therapeutic options in peripheral T cell lymphoma. Journal of Hematology & Oncology. 2016 (9): 37.
Schmitz N, Trumper L, Ziepert M, et al. Treatment and prognosis of mature T-cell and NK-cell lymphoma: an analysis of patients with T-cell lymphoma treated in studies of the German high-grade non-Hodgkin lymphoma study group. Blood. 2010; 116 (18): 3418-3425.
Mak V, Hamm J, Chhanabhai M, Shenkier T, Klasa R, Sehn LH, Villa D, Gascoyne RD, Connors JM, and Savage KJ. Survival of Patients With Peripheral T-Cell Lymphoma After First Relapse or Progression: Spectrum of Disease and Rare Long-Term Survivors. J Clin Oncol 2013; 31 (16): 1970-1976.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th Edition, IARC 2008.
Foss FM, Zinzani PL, Vose JM, et al. Peripheral T-cell lymphoma. Blood. 2011; 117 (25): 6756-6767.
Parrilla Castellar ER, Jaffe ES, Said JW, Swerdlow SH, Ketterling RP, Knudson RA, Sidhu JS, Hsi ED, Karikehalli S, Jiang L, Vasmatzis G, Gibson SE, Ondrejka S, Nicolae A, Grogg KL, Allmer C, Ristow KM, Wilson WH, Macon WR, Law ME, Cerhan JR, Habermann TM, Ansell SM, Dogan A, Maurer MJ, and Feldman AL. ALK-negative anaplastic large cell lymphoma is a genetically heterogeneous disease with widely disparate clinical outcomes. Blood. 2014; 124 (9): 1473–1480.
Edupuganti S, Xie C, Huang J, Chen X, Wey E, and Xie M. Clinicopathological Features of Primary Bone Marrow Mature T and NK Cell Neoplasms. J J Cancer Sci Res. 2016, 2 (7): 046.
Skarbnik AP, Burki M and Pro B. Peripheral T-cell lymphomas: a review of current approaches and hopes for the future. Frontiers in Oncology. 2013; 3 (138): 1-9.
Broccoli A and Zinzani PL. Peripheral T-cell lymphoma, not otherwise specified. Blood First Edition Paper, 2017; DOI 10.1182/blood-2016-08-692566.
Vose JM. Peripheral T-cell Non-Hodgkin’s lymphoma. Hematology/oncology Clinics of North America. 2008; 22 (5): 997-1005.
The Leukemia & Lymphoma Society. Peripheral T-Cell Lymphoma Facts. July 2014; page 1-8.
Ma X. Epidemiology of Myelodysplastic Syndromes. Am J Med. 2012; 125 (7 Suppl): S2–S5.
Ria R, Moschetta M, Reale A, Mangialardi G, Castrovilli A, Vacca A, and Dammacco F. Managing myelodysplastic symptoms in elderly patients. Clinical Interventions in Aging. 2009; (4): 413–423.
Luckheeram RV, Zhou R, Verma AD, and Xia B. CD4+T Cells: Differentiation and Functions. Clinical and Developmental Immunology. 2012, Article ID 925135, 12 pages.
Drayton DL, Liao S, Mounzer RH, and Ruddle NH. “Lymphoid organ development: from ontogeny to neogenesis,” Nature Immunology, 2006; 7 (4): 344–353.
Monteiro JP, Benjamin A, Costa ES, Barcinski MA, and Bonomo A. Normal hematopoiesis is maintained by activated bone marrow CD4+ T cells. Blood. 2005; 105: 1484-1491.
Broxmeyer HE, Bruns HA, Zhang S, et al. Th1 cells regulate hematopoietic progenitor cell homeostasis by production of oncostatin M. Immunity. 2002; 16: 815-825.
Science Publishing Group
NEW YORK, NY 10018
Tel: (001)347-688-8931