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T-Cell Lymphoma Prognosis: Outcomes and Survival Rates

Posted on July 30, 2021
Medically reviewed by
Mark Levin, M.D.
Article written by
Kristopher Bunting, M.D.

There are many types of T-cell lymphoma, and each one has varying outcomes and survival rates. T-cell lymphomas are non-Hodgkin lymphomas (NHLs) that affect white blood cells called T cells (also called T lymphocytes) and natural killer (NK) cells. Lymphoma can form tumors in the lymphatic system — the part of the immune system that includes the lymph nodes, spleen, tonsils, and other organs that help remove bacteria, waste, and excess fluid from tissue. Together, all T-cell lymphomas account for less than 15 percent of all NHLs.

T-cell lymphomas can be aggressive (fast-growing) or indolent (slow-growing) and can occur in the lymph nodes, skin (cutaneous T-cell lymphomas), or other parts of the body (peripheral T-cell lymphomas).

Understanding Measures of Outcome and Survival

There are different ways to describe the outcome of lymphoma. Some of these measures include rates of remission, relapse, and survival. Survival statistics can include:

  • Disease-free survival rate or relapse-free survival rate
  • Progression-free survival
  • Overall survival

Outcomes and survival are often described in terms of the five-year relative survival (RS) rate. The five-year RS rate describes how likely a person will live for five years after diagnosis compared to people in the general population. Five-year survival is often thought to be synonymous with a cure. However, it's possible for undetected cancer cells to remain in one's body after treatment and for the cancer to return. Two-year survival is another measure that correlates with prognosis in lymphomas.

Survival Rates by Type of T-Cell Lymphoma

T-cell lymphoma subtypes have different survival rates. Five-year RS can vary based on age, and younger people with T-cell lymphomas typically have a higher survival rate than adults. Those with T-cell lymphomas that occur only in adults generally tend to have a lower survival rate.

Non-Hodgkin Lymphoma and T-Cell Non-Hodgkin Lymphoma

Overall, people with non-Hodgkin lymphoma (including T-cell lymphoma along with other types) have a five-year RS of 66.9 percent. Those with T-cell NHL specifically have a slightly lower survival rate of 63.1 percent. Survival may be further broken down by type of T-cell NHL.

Aggressive T-Cell Lymphomas

There are several types of aggressive T-cell lymphomas:

  • T-cell lymphoblastic lymphoma — 62.4 percent
  • Anaplastic large cell lymphoma — 58.1 percent (85.2 percent for children and teens and 32 percent for people 65 and older)
  • Adult T-cell lymphoma/leukemia — 57 percent (82.7 percent in children and teens and 19.8 percent in adults 65 and older)
  • Sezary syndrome — 44.1 percent
  • Angioimmunoblastic T-cell lymphoma — 43.4 percent
  • Extranodal natural killer (NK)/T-cell lymphoma (NK/T-cell lymphoma) — 41.6 percent
  • Peripheral T-cell lymphoma, not otherwise specified — 37 percent (60.4 percent for children and teens and 29.1 percent in people 65 and older)
  • Enteropathy-associated intestinal T-cell lymphoma — 13.3 percent

Indolent T-Cell Lymphomas

Types of indolent (slow-growing) T-cell lymphomas include:

  • Primary cutaneous anaplastic large cell lymphoma — 90.9 percent
  • Mycosis fungoides — 90.6 percent
  • Cutaneous T-cell lymphoma — 81.1 percent

Factors That Influence Outcomes

The numbers above do not take into account several factors that may influence a person’s prognosis (disease outlook, or chance of survival), including:

  • The stage of lymphoma at diagnosis — Diagnosis at an early stage, rather than an advanced stage, usually leads to a better prognosis.
  • The International Prognostic Index (IPI) score — People with IPI scores that are classified as high risk may have poor outcomes and a poor prognosis.
  • Types of treatment used — As new treatments become available, survival continues to edge up.

Although many T-cell lymphomas have well-established treatments with proven effectiveness, some T-cell lymphomas — especially rare types with low incidence — may not. If there are not enough cases of lymphoma for prospective (forward-looking) studies to develop better treatments, the only way to determine potentially effective therapies may be through retrospective (backward-looking) studies that look at what treatments have been attempted in the past. Stem cell transplantation to restore bone marrow can help salvage relapsed or refractory cases. A newer treatment called 3D conformal radiation therapy is used for more resistant cases.

Long-Term Effects and Late Effects

Other T-cell lymphoma outcomes that are important to consider are potential long-term and late effects of both the disease and its treatment. Long-term effects are side effects that last, and late effects are side effects that are delayed. Late effects may not appear until months or years after treatment.

For example, having or treating lymphoma can increase your risk of developing second cancers, including another type of lymphoma and other types of cancer. Other long-term and late effects include conditions that affect the heart, lungs, thyroid, brain, digestive tract, and other parts of the body.

Surviving T-cell lymphoma and other types of cancer involves more than just treating the disease. Long-term, regular follow-up with your health care provider, including periodic blood and imaging tests, is typically required after treatment to check for relapsed lymphoma and address long-term and late effects of treatment. People can live normal life spans after diagnosis and treatment of lymphoma.

What Does This Mean for You?

The survival rates for some T-cell lymphomas may be poor, but statistics do not tell the whole story. Knowing the five-year RS rate can give you a good idea of what the likely outcomes are for various T-cell lymphomas, but it is not a reliable indicator of a person’s expected outcome. Survival rates also do not take into account quality of life, which can be one of the most important factors in deciding how to deal with a life-changing disease like cancer.

Knowing the predicted outcome of the disease can be a source of hope after a frightening diagnosis, or it can force you to manage your expectations. Regardless of the outcome, knowing what to expect after you are diagnosed with cancer is a key part of coping with what is often a sudden and unexpected event in your life.

Talk With Others Who Understand

MyLymphomaTeam is the social network for people with lymphoma and their loved ones. On MyLymphomaTeam, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Are you or someone you care about living with T-cell lymphoma? Share your experience in the comments below, or start a conversation by posting on MyLymphomaTeam.

All updates must be accompanied by text or a picture.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Kristopher Bunting, M.D. studied chemistry and life sciences at the U.S. Military Academy, West Point, and received his doctor of medicine degree from Tulane University. Learn more about him here.

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