Angioimmunoblastic T-cell lymphoma in Taiwan reveals worse progression-free survival for <i>RHOA</i> G17V mutated subtype

Abstract

Angioimmunoblastic T-cell lymphoma (AITL) carries genetic mutations of <i>TET2</i>, <i>RHOA</i>, and <i>IDH2</i>, but the prognostic impact of these mutations is not widely investigated. Although one study shows no difference in overall survival between patients with or without <i>RHOA</i> G17V mutation, a poor performance status is associated with <i>RHOA</i> G17V-mutated AITL, which is an independent adverse factor. We retrospectively investigated the prognostic impact of <i>RHOA</i> G17V mutation in AITL patients. A total of 31 cases were enrolled (male-to-female, 2.1; mean age: 62.8 years). <i>RHOA</i> G17V mutation was analyzed by deep sequencing. We found that in contrast to <i>RHOA</i>-wild type, patients with <i>RHOA</i> G17V-mutated AITL more frequently had B symptoms (<i>p</i> = .035), stronger PD1 expression (<i>p</i> = .045), ≥3 TFH markers (<i>p</i> = .011), higher blood vessel density (<i>p</i><.001), and poorer progression-free survival (<i>p</i> = .046). These results support a role for <i>RHOA</i> genetic testing in AITL patients as <i>ROHA</i> G17V mutation carries a worse prognosis, probably associated with B symptoms and stage IV disease.