Introduction: The real-world treatment patterns and prognosis of patients with R/R mature T-cell and natural killer-cell lymphoma (MTNKL) in this new treatment era remains unclear.
Objectives: We elucidated second-line (2L) therapy outcomes and treatment patterns for R/R MTNKL.
Methods: This multicenter, retrospective study included patients aged ≥18 years who initiated 2L R/R MTNKL therapy between April 2018 and March 2023 in Japan. Diagnoses included PTCL-NOS, TFHL, ALK+ALCL, ALK-ALCL, BIA-ALCL, ENKTL, and MF with LCT, based on revised 4th WHO classification. Endpoints were overall survival (OS) after 2L therapy (OS-2L), time to next treatment (TTNT), and treatment patterns.
Results: Among 256 patients (median age 66 years; 66% male), histological subtypes included PTCL-NOS (40%), TFHL (38%), ENKTL (11%), ALK+ALCL (6%), ALK-ALCL (3%), MF with LCT (2%), and BIA-ALCL (0%). Extranodal involvement was observed in 54%, high IPI scores (3–5) in 41%, and 40% were refractory to first-line therapy. Median OS-2L was 18.3 months (95% CI, 14.8–27.9), varying with lymphoma subtype. Nine new single-agents (SAs) were used in 54% of patients aged ≥65 years and 12% < 65 years in 2L. During and after 2L, HSCT was performed in 13% (autologous) and 18% (allogeneic) of patients. OS-2L was longer in HSCT recipients (NR [28.3–NE]) than in non-recipients (13.1 [9.6–16.8]). No significant differences in OS-2L or TTNT were observed between SAs and conventional multiagent-chemotherapies (CCs) in 2L.
Conclusions: This study reports the most recent treatment patterns and outcomes for R/R MTNKL. SAs achieved survival comparable to CCs in 2L therapy. ©American Society of Hematology (2025). Reused with permission.
