Introduction:
Mature T-cell lymphomas, including aggressive nodal PTCL, advanced CTCL, and extranodal cytotoxic lymphomas, often have poor outcomes. Cytogenetic abnormalities are common, but their prognostic relevance remains unclear. We evaluated the impact of karyotype (KT) abnormalities, including complex KT and specific chromosomal lesions, along with clinical and demographic factors, on OS in a single-center cohort.
Methods:
We retrospectively reviewed 189 patients (pts) with T-cell lymphomas who had successful metaphase KT from PB, BM, or tissue at diagnosis. Subtypes were classified by WHO 2022. CTCLs were categorized as indolent or aggressive. KTs were classified as normal, abnormal, or complex (3 >=). Recurrent chromosomal abnormalities and baseline clinical data were recorded. OS was estimated using KM. Factors associated with OS were identified using univariate and multivariate CPH models.
Results:
Median age was 66. 60% had aggressive nodal PTCL, 16% early CTCL, 13% aggressive CTCL, and 12% extranodal lymphomas. Overall, 25% had an abnormal KT and 16% had complex KT. Aggressive CTCL showed the highest rate of complex KT (42%). Key abnormalities included gains of chromosomes 1,3,7, and 8, monosomy5, monosomy9, monosomy10, loss of Y.
Median OS was 95 months. Normal KT had median OS of 143 months versus 34 months for abnormal KT. Pts with complex KT had OS of 14 months versus 144 months without. Several lesions showed very poor OS (range 2-30 months).
On multivariate CPH, complex KT (HR 3.1), monosomy9 (HR=4.4), gain of chr1 (HR=3.5), and low platelet count (HR=0.98) remained independent predictors of inferior OS.
Conclusion:
Cytogenetic abnormalities, especially complex KT and select chromosomal lesions, strongly predict poor survival in mature T-cell lymphomas. Integrating KT data with clinical factors may refine risk stratification and guide therapy.
