Clinical features and survival outcome of aggressive splenic lymphoma: a retrospective study

Abstract Purpose The present study aims to explore the clinical features, imaging manifestations, pathologic characteristics, treatment, and prognosis of aggressive splenic lymphoma (ASL) patients.Methods From January 2001 to March 2021, patients who were histologically proven splenic lymphoma were enrolled in this study. The survival curves of overall survival (OS) and progressive-free survival (PFS) were calculated by the Kaplan–Meier survival analysis and log-rank test. Univariate and multivariate Cox regression analyses were performed to estimate the potential prognostic factors.Results Sixty-nine patients who were histologically proven ASL in this study. The median follow-up time was 76.3 months (95%CI, 60.194-92.406). Patients with ASL underwent the splenectomy had better PFS and OS than that of patients who did not (OS 61% vs 35%, P=0.084; PFS 57% vs 25%, P=0.061), yet the difference was not remarkably significant. In addition, splenic lymphomas of T-cell origin (OS HR, 3.398[95%CI, 1.327-8.704], P=0.011; PFS HR, 2.776[95%CI, 1.107-6.959], P=0.029) and present with B symptoms (OS HR, 2.703[95%CI, 1.219-5.994], P=0.014; PFS HR, 2.890[95%CI, 1.348-6.194], P=0.006) were independent risk factors correlated with OS and PFS. After establishing a risk-stratified model in combination with cell of origin (COO) and B symptom to divide patients into three risk subgroups: 36 were in low-risk group, 28 were in intermediate-risk group, and 5 were in high-risk group. The differences between each group were statistically significant (OS: χ2=41.000, P<0.001; PFS: χ2=47.739, P<0.001).Conclusion Splenic T-cell lymphoma patients with B symptom at initial diagnosis had the worst outcome among aggressive splenic lymphoma.