Real-world outcomes of T cell lymphoma in a tertiary cancer center in Saudi Arabia
Sultan Alqahtani, Mohammed Assiri, Abdullah Bin Abdu, Khalid Alyusif, Mohammed Alharbi, Ziyad Alharbi, Ali Alsubaie, Abdullah Alhamzani, Saud Alghamdi, Saeed AlshibaniBACKGROUND:
T-cell and natural-killer (T/NK)–cell lymphomas are rare and aggressive malignancies. Prior to our study, no dedicated institutional survival analyses of T/NK-cell lymphomas had been published from Saudi Arabia.
OBJECTIVES:
To evaluate the clinical characteristics, prognostic factors, and survival outcomes of patients with T/NK-cell lymphoma treated at a tertiary cancer referral centre in Saudi Arabia.
DESIGN:
Retrospective cohort study
SETTING:
King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Riyadh, Saudi Arabia; January 2016 to December 2022.
PATIENTS AND METHODS:
We reviewed medical records of 89 adults with histologically confirmed T/NK-cell lymphomas, including precursor and mature subtypes. Overall survival (OS) was estimated using the Kaplan–Meier method. Prognostic factors were assessed with univariate and multivariable Cox proportional hazards regression. To maintain a robust events-per-variable ratio, the multivariable model was restricted to four predictors.
MAIN OUTCOME MEASURES:
Five-year overall survival and identification of variables associated with mortality.
SAMPLE SIZE:
89 patients
RESULTS:
The mean age was 49.5±20.5 years, and 62 patients (70%) were male. The most common subtypes were ALK-negative anaplastic large-cell lymphoma (n=20, 22%) and peripheral T-cell lymphoma, not otherwise specified (n=15, 17%). For the entire cohort (N=89), the 5-year OS was 56% (95% CI, 44%–67%); the Kaplan–Meier estimated mean OS over the full available follow-up was 116.4 months. In multivariable analysis restricted to 70 patients with complete data (26 deaths), elevated lactate dehydrogenase (LDH) (hazard ratio [HR]=7.66; 95% confidence interval [CI], 1.77-33.19;
CONCLUSION:
Elevated LDH, poor performance status, and renal insufficiency are strong independent predictors of inferior survival. Stem cell transplantation did not demonstrate a survival benefit in this cohort. These findings underscore the importance of baseline laboratory and clinical variables for risk stratification and provide groundwork for multicentre studies and therapeutic optimisation in Saudi Arabia.
LIMITATIONS:
Sample size and single-centre retrospective design limit generalisability. Transplant-specific details in treatment regimens were not evaluated.