Background: Peripheral T cell lymphoma (PTCL) is relatively uncommon compared to B cell lymphoma, however, it generally carries worse prognosis. Treatment failure and early relapse are major dilemma of PTCL. Identification of high-risk patients using various tools may better refine long-term prognosis of PTCL patients. There were data indicating event free survival (EFS) at 12 months (EFS12) and 24 months (EFS24) as strong surrogate predictors for disease-related outcomes in many B-cell lymphoma. However, the implication of such surrogate end-points has been limited in PTCL. Herein, we explored EFS12 and EFS24 as tools to stratify survival outcome in PTCL patients. Methods: Thai Lymphoma Study Group is the nationwide collaborative effort composing of 13 major medical centers in Thailand. The registry prospectively enrolled newly diagnosed lymphoma patients between 2006 and 2014. Here, we focused on systemic PTCL treated with chemotherapy and had adequate follow-up data. EFS was defined as time between primary treatment to relapse, re-treatment, or death from any causes. EFS12 and EFS24 were binary endpoints defined as whether developing events at 12 and 24 months after treatment initiation. Overall survival (OS) was defined as time from a specific timepoints either diagnosis or EFS12 to death. Logistic regression model was used to evaluate associations between clinical characteristics and EFS12/EFS24. Cox regression with EFS12/EFS24 as a time-dependent covariate was applied to evaluate the association between EFS12 and OS. Results: Of 353 PTCL, 292 (83%) received multiagent chemotherapy. Median age at diagnosis was 49 years (IQR 36-60 years). Median EFS and OS of patients who received treatment were 16.3 and 27.7 months (CI 95% 12.6-28.3 and 18.8-50.4 months respectively). A total of 138 patients (47.1%) developed an event within 12 months after treatment initiation (failed to achieve EFS12). Patients who failed to achieve EFS12 had higher proportion of impaired performance status, high IPI, and presence of B symptoms. After a median follow-up of 53.7 months, Patients who achieved EFS12 had superior OS compared to patients who failed to achieve EFS12 (5-years OS after treatment initiation 70.5% vs 12%, HR 7.0, p<0.001). Landmark analysis confirmed the association between EFS12 and OS after 12 months timepoint (5-years OS after EFS12 67.5% vs 11.5%, HR 6.45, p<0.001). Similar results were seen with patients who achieved EFS24 for both survival after treatment initiation and after 24 months timepoint (Figure 1). Keywords: peripheral T-cell lymphomas (PTCL); prognostic indices; T-cell lymphoma (TCL).

To gain more insight into the understanding of myelodysplastic syndromes (MDS) as they occur in Thailand, a retrospective clinicopathologic analysis was conducted in patients (age >15 years) diagnosed as MDS from January 1992 to December 1996 at the five major medical centers in various geographic regions of the country. The central reviewers independently examined the bone marrow and peripheral blood smears of all the patients and classify the disease according to the French-British-American (FAB) classification. There were a total of 117 eligible patients. The median age of the patients was 56 years (range 16–86). The male:female ratio was 1:1. Thirty-two percent of the patients were younger than 40 years. The frequency of the FAB subtypes was RA/RARS, 54.7; RAEB, 23.1; CMML, 9.4; and RAEB-T, 12.8%. Anemia was the most common symptom presenting in 84.6% of the patients. In the 34 patients in whom the cytogenetics in the bone marrow were analysed, 44.1% revealed abnormalities. Of these, monosomy 7 and trisomy 8 were the most common aberration, each being detected in 26.7% of the patients. Transfusions were the main therapeutic modality in 80% of the patients. Kaplan–Meier analysis revealed a 5 year survival rate of 29% for the whole group with a median survival of 24 months. Twenty-five percent of the patients had progressed to acute myelogenous leukemia (AML) with a median time to disease-progression of 23 months. The median survival for RA/RARS, RAEB, CMML and RAEB-T were 58.4, 19.9, 10.7 and 8.7 months, respectively (P<0.001). The stepwise Cox regression analysis revealed the percentage of blasts in the bone marrow as the only parameter significantly associated with survival and disease progression. On comparison with data from other countries, the age of Thai patients with MDS is considerably lower than the western population but is comparable to other asian countries. The distribution of the FAB subtypes and the survival of the patients are similar. The major prognostic features, however, lie in the percentage of blasts in the bone marrow rather than the degree of the observed cytopenia.

summary. The relationship of socioeconomic status to the risk of aplastic anaemia was evaluated in a case‐control study conducted in Bangkok and two rural regions of Thailand (Khonkaen and Songkla). Among 152 cases and 921 controls there were significant trends of increasing risk with decreasing years of education (P = O01) and total household income (P = 0–0001), after control for confounding. The relative risk estimate for those with monthly incomes of >1500 baht (about 60 U.S.) was 3–9 (95% confidence interval 2–1–7–3) compared to those with monthly incomes of at least 5000 baht (about 200). The pattern of increasing risk with decreasing income was observed in all three regions, with significant trends in Bangkok (P= 0–004) and Khonkaen (P = 0–003). This finding may partly explain the high incidence of aplastic anaemia in Thailand. Low socioeconomic status may be a surrogate for one or more environmental factors that could cause aplastic anaemia, such as infectious pathogens or toxic exposures.