Peripheral T-cell lymphoma (PTCL) is a clinically used family of aggressive mature T-cell non-Hodgkin lymphomas dominated in nodal and systemic practice by PTCL-not otherwise specified (PTCL-NOS), nodal T-follicular helper (TFH) lymphomas, and systemic anaplastic large cell lymphomas (ALCL). PTCL biology is heterogeneous, with subtype-weighted contributions from TFH-lineage epigenetic lesions, RHOA/VAV1-mediated T-cell receptor signaling, PTCL-NOS GATA3/TBX21 transcriptional programs, and an immune microenvironment enriched in regulatory and exhausted T cells. Following the cancer-modeling guidance from dismech issue # 1198, this entry treats PTCL as a single mechanism-graph unit and keeps clinically meaningful histologic entities as flat subtype facets rather than separate dismech pages. Because MONDO lacks an exact family-level peripheral T-cell lymphoma umbrella term, the page is anchored to the closest MONDO family class and refined with subtype-specific NCIT histopathology and oncology treatment terms.
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name: Peripheral T-Cell Lymphoma
creation_date: '2026-04-13T05:36:37Z'
updated_date: '2026-04-13T05:36:37Z'
synonyms:
- PTCL
- peripheral T-cell lymphoma
description: >-
Peripheral T-cell lymphoma (PTCL) is a clinically used family of aggressive
mature T-cell non-Hodgkin lymphomas dominated in nodal and systemic practice
by PTCL-not otherwise specified (PTCL-NOS), nodal T-follicular helper (TFH)
lymphomas, and systemic anaplastic large cell lymphomas (ALCL). PTCL biology
is heterogeneous, with subtype-weighted contributions from TFH-lineage
epigenetic lesions, RHOA/VAV1-mediated T-cell receptor signaling, PTCL-NOS
GATA3/TBX21 transcriptional programs, and an immune microenvironment enriched
in regulatory and exhausted T cells. Following the cancer-modeling guidance
from dismech issue # 1198, this entry treats PTCL as a single mechanism-graph
unit and keeps clinically meaningful histologic entities as flat subtype facets
rather than separate dismech pages. Because MONDO lacks an exact family-level
peripheral T-cell lymphoma umbrella term, the page is anchored to the closest
MONDO family class and refined with subtype-specific NCIT histopathology and
oncology treatment terms.
definitions:
- name: Family-level clinical definition of peripheral T-cell lymphoma
definition_type: CASE_DEFINITION
description: >-
Peripheral T-cell lymphomas are uncommon aggressive mature T-cell lymphomas
that are operationally modeled here as the nodal and systemic PTCL family,
with PTCL-NOS, nodal TFH lymphomas, and systemic ALCL represented as flat
subtype facets.
scope: >-
Disease-level family definition aligned to current nodal and systemic PTCL
practice and used as the curation unit for this dismech page.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells."
explanation: >-
This review provides the family-level definition for PTCL as an uncommon
mature T-cell lymphoma group.
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "According to their presentation, PTCLs can be divided into nodal, extranodal or cutaneous, and leukemic types."
explanation: >-
This supports modeling PTCL as a family-level curation unit with flat
subtype facets rather than a single narrow ontology subclass.
categories:
- Hematologic Malignancy
- T-cell lymphoma
- Non-Hodgkin Lymphoma
parents:
- T-cell lymphoma
disease_term:
preferred_term: peripheral T-cell lymphoma
term:
id: MONDO:0015760
label: T-cell non-Hodgkin lymphoma
has_subtypes:
- name: PTCL-NOS
display_name: Peripheral T-Cell Lymphoma, Not Otherwise Specified
subtype_term:
preferred_term: peripheral T-cell lymphoma, not otherwise specified
term:
id: MONDO:0004964
label: peripheral T-cell lymphoma, not otherwise specified
description: >-
Default nodal and systemic PTCL category used when a mature T-cell lymphoma
does not meet criteria for TFH lymphoma or systemic ALCL. PTCL-NOS is
biologically heterogeneous and includes clinically important GATA3 and TBX21
transcriptional programs.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified."
explanation: >-
This supports PTCL-NOS as a core subtype within the nodal and systemic
PTCL family.
- reference: PMID:31562134
reference_title: "Reproducing the molecular subclassification of peripheral T-cell lymphoma-NOS by immunohistochemistry."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of mature T-cell malignancies; approximately one-third of cases are designated as PTCL-not otherwise specified (PTCL-NOS)."
explanation: >-
This supports PTCL-NOS as a common and clinically meaningful PTCL subtype.
- name: TFH Angioimmunoblastic-Type
display_name: Follicular Helper T-Cell Lymphoma, Angioimmunoblastic-Type
subtype_term:
preferred_term: angioimmunoblastic T-cell lymphoma
term:
id: MONDO:0004977
label: angioimmunoblastic T-cell lymphoma
description: >-
Nodal TFH lymphoma subtype with angioimmunoblastic morphology, frequent
epigenetic modifier mutations, and prominent immune-microenvironmental
remodeling.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This review defines angioimmunoblastic-type TFH lymphoma as one of the
three major nodal TFH lymphoma subtypes.
- name: TFH Follicular-Type
display_name: Nodal T-Follicular Helper Cell Lymphoma, Follicular Type
subtype_term:
preferred_term: nodal T-follicular helper cell lymphoma, follicular type
term:
id: MONDO:0958095
label: Nodal T-follicular helper cell lymphoma, follicular type
description: >-
Nodal TFH lymphoma subtype with follicular architecture and the TFH-lineage
mutational profile shared across the nodal TFH lymphoma spectrum.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This review defines follicular-type TFH lymphoma as one of the three major
nodal TFH lymphoma subtypes.
- name: TFH NOS
display_name: Follicular Helper T-Cell Lymphoma, Not Otherwise Specified
description: >-
Nodal TFH lymphoma subtype that shows TFH immunophenotypic and molecular
features but lacks the defining architecture of the angioimmunoblastic-type
or follicular-type entities.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This review defines TFH lymphoma, NOS as one of the three major nodal TFH
lymphoma subtypes.
- name: ALK-Positive ALCL
display_name: ALK-Positive Anaplastic Large Cell Lymphoma
subtype_term:
preferred_term: ALK-positive anaplastic large cell lymphoma
term:
id: MONDO:0017602
label: ALK-positive anaplastic large cell lymphoma
description: >-
Systemic ALCL subtype driven by ALK rearrangement and generally associated
with better outcomes than most other PTCL entities.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified."
explanation: >-
This supports ALK-positive ALCL as a core nodal and systemic PTCL subtype.
- name: ALK-Negative ALCL
display_name: ALK-Negative Anaplastic Large Cell Lymphoma
subtype_term:
preferred_term: ALK-negative anaplastic large cell lymphoma
term:
id: MONDO:0017603
label: ALK-negative anaplastic large cell lymphoma
description: >-
Systemic ALCL subtype lacking ALK rearrangement and showing greater genetic
heterogeneity than ALK-positive ALCL.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified."
explanation: >-
This supports ALK-negative ALCL as a core nodal and systemic PTCL subtype.
prevalence:
- population: All non-Hodgkin lymphomas in Western countries
percentage: 10
notes: Approximate relative share of PTCL among Western non-Hodgkin lymphomas.
evidence:
- reference: PMID:21138864
reference_title: "New strategies in peripheral T-cell lymphoma: understanding tumor biology and developing novel therapies."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphomas (PTCL) constitute a group of heterogeneous diseases that are uncommon, representing, in Western countries, only approximately 10% of all non-Hodgkin lymphomas."
explanation: >-
This review provides a commonly cited family-level prevalence estimate for
PTCL in Western countries.
progression:
- phase: Diagnosis
age_range: Adult to elderly
notes: PTCL predominantly presents in adults and older patients and usually has an aggressive clinical course.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "They predominantly affect adults and elderly people and usually exhibit an aggressive clinical course with poor prognosis."
explanation: >-
This supports the typical adult-to-elderly age at presentation and the
aggressive behavior of PTCL.
- phase: Front-line outcome
notes: Durable control is possible, but most PTCL-related deaths occur within 5 years of diagnosis.
evidence:
- reference: PMID:38532575
reference_title: "Long-term outcome of peripheral T-cell lymphomas: Ten-year follow-up of the International Prospective T-cell Project."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The overall response rate to first-line therapy was 68%, while 5- and 10-year overall survival estimates were 49% and 40% respectively."
explanation: >-
This prospective cohort provides the long-term outcome benchmark for the
PTCL family.
- reference: PMID:38532575
reference_title: "Long-term outcome of peripheral T-cell lymphomas: Ten-year follow-up of the International Prospective T-cell Project."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Most deaths occurred prior to 5 years, and for patients alive at 5 years, the chance of surviving to 10 years was 84%."
explanation: >-
This supports the front-loaded mortality pattern of PTCL despite a subset
of patients achieving durable disease control.
pathophysiology:
- name: TFH-lineage epigenetic deregulation
description: >-
A major PTCL branch consists of nodal TFH lymphomas in which recurrent
mutations in epigenetic regulators distort chromatin state and stabilize
malignant TFH-cell identity.
cell_types:
- preferred_term: T follicular helper cell
term:
id: CL:0002038
label: T follicular helper cell
biological_processes:
- preferred_term: chromatin organization
modifier: DYSREGULATED
term:
id: GO:0006325
label: chromatin organization
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "These neoplasms feature a characteristic and similar, but not identical, mutational landscape with mutations in epigenetic modifiers (TET2, DNMT3A, IDH2), RHOA, and T-cell receptor signaling genes."
explanation: >-
This supports epigenetic deregulation as a defining mechanistic branch of
nodal TFH lymphomas within the PTCL family.
- reference: PMID:37841428
reference_title: "Biological insights into the role of TET2 in T cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Mutations in the epigenetic regulator TET2 are among the most frequent mutations identified in PTCL, with the highest frequency in angioimmunoblastic T cell lymphomas and other nodal T follicular helper (TFH) lymphomas."
explanation: >-
This supports TET2-centered epigenetic disruption as especially prominent
in TFH-derived PTCL.
- name: TFH Angioimmunoblastic-Type RHOA-VAV1-mediated T-cell receptor signaling activation
description: >-
In angioimmunoblastic-type TFH lymphoma, hotspot RHOA lesions can rewire
VAV1 adaptor signaling and accelerate downstream T-cell receptor signaling.
cell_types:
- preferred_term: T follicular helper cell
term:
id: CL:0002038
label: T follicular helper cell
biological_processes:
- preferred_term: T cell receptor signaling pathway
modifier: INCREASED
term:
id: GO:0050852
label: T cell receptor signaling pathway
evidence:
- reference: PMID:28832024
reference_title: "Activation of RHOA-VAV1 signaling in angioimmunoblastic T-cell lymphoma."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: "We found that binding of G17V RHOA to VAV1 augmented its adaptor function through phosphorylation of 174Tyr, resulting in acceleration of T-cell receptor (TCR) signaling."
explanation: >-
This mechanistic study directly supports RHOA-VAV1-mediated acceleration
of T-cell receptor signaling in angioimmunoblastic-type TFH lymphoma.
downstream:
- target: TFH Angioimmunoblastic-Type cytokine and chemokine program induction
description: G17V RHOA expression is accompanied by activation of cytokine and chemokine pathway programs.
evidence:
- reference: PMID:28832024
reference_title: "Activation of RHOA-VAV1 signaling in angioimmunoblastic T-cell lymphoma."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: "Enrichment of cytokine and chemokine-related pathways was also evident by the expression of G17V RHOA."
explanation: >-
This supports a direct downstream link from aberrant RHOA-VAV1 signaling
to cytokine and chemokine pathway induction.
- name: TFH Angioimmunoblastic-Type cytokine and chemokine program induction
description: >-
Aberrant TFH-cell signaling promotes a cytokine- and chemokine-rich program
that contributes to the inflammatory and immune-remodeling features of
angioimmunoblastic-type PTCL.
biological_processes:
- preferred_term: positive regulation of cytokine production
modifier: INCREASED
term:
id: GO:0001819
label: positive regulation of cytokine production
evidence:
- reference: PMID:28832024
reference_title: "Activation of RHOA-VAV1 signaling in angioimmunoblastic T-cell lymphoma."
supports: SUPPORT
evidence_source: IN_VITRO
snippet: "Enrichment of cytokine and chemokine-related pathways was also evident by the expression of G17V RHOA."
explanation: >-
This supports cytokine and chemokine program induction as a distinct
downstream mechanism in angioimmunoblastic-type TFH lymphoma.
- name: PTCL-NOS transcriptional polarization
description: >-
PTCL-NOS separates into reproducible GATA3 and TBX21 programs with distinct
biology and prognosis rather than representing a single uniform disease state.
biological_processes:
- preferred_term: regulation of T cell differentiation
modifier: DYSREGULATED
term:
id: GO:0045580
label: regulation of T cell differentiation
evidence:
- reference: PMID:31562134
reference_title: "Reproducing the molecular subclassification of peripheral T-cell lymphoma-NOS by immunohistochemistry."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Using gene-expression profiling (GEP), we have previously defined 2 major molecular subtypes of PTCL-NOS, PTCL-GATA3 and PTCL-TBX21, which have distinct biological differences in oncogenic pathways and prognosis."
explanation: >-
This supports PTCL-NOS as a mechanistically polarized subtype with at least
two major transcriptional programs.
downstream:
- target: PTCL-NOS GATA3 oncogenic pathway activation
description: One PTCL-NOS branch is GATA3-skewed and genetically complex.
- target: PTCL-NOS DNMT3A-linked cytotoxic program
description: Another PTCL-NOS branch is TBX21/cytotoxic and enriched for epigenetic dysregulation.
- name: PTCL-NOS GATA3 oncogenic pathway activation
description: >-
The GATA3-polarized PTCL-NOS program is marked by genomic complexity with
lesions converging on tumor-suppressor loss, PI3K pathway dysregulation, and
JAK/STAT-MYC signaling.
biological_processes:
- preferred_term: cell surface receptor signaling pathway via JAK-STAT
modifier: INCREASED
term:
id: GO:0007259
label: cell surface receptor signaling pathway via JAK-STAT
- preferred_term: positive regulation of cell population proliferation
modifier: INCREASED
term:
id: GO:0008284
label: positive regulation of cell population proliferation
evidence:
- reference: PMID:30782609
reference_title: "Genetic drivers of oncogenic pathways in molecular subgroups of peripheral T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "PTCL-GATA3 exhibited greater genomic complexity that was characterized by frequent loss or mutation of tumor suppressor genes targeting the CDKN2A /B-TP53 axis and PTEN-PI3K pathways. Co-occurring gains/amplifications of STAT3 and MYC occurred in PTCL-GATA3."
explanation: >-
This supports a distinct PTCL-GATA3 oncogenic program centered on
proliferative and receptor-signaling pathway lesions.
- name: PTCL-NOS DNMT3A-linked cytotoxic program
description: >-
A DNMT3A-mutant PTCL-TBX21 branch shows epigenetically rewired cytotoxic
T-cell programs coupled to interferon-gamma and T-cell receptor signaling genes.
cell_types:
- preferred_term: CD8-positive, alpha-beta cytotoxic T cell
term:
id: CL:0000794
label: CD8-positive, alpha-beta cytotoxic T cell
biological_processes:
- preferred_term: chromatin organization
modifier: DYSREGULATED
term:
id: GO:0006325
label: chromatin organization
- preferred_term: regulation of T cell differentiation
modifier: DYSREGULATED
term:
id: GO:0045580
label: regulation of T cell differentiation
evidence:
- reference: PMID:35639959
reference_title: "DNMT3A mutations define a unique biological and prognostic subgroup associated with cytotoxic T cells in PTCL-NOS."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Genomewide methylation analysis of DNMT3A-mutant vs wild-type (WT) PTCL-TBX21 cases demonstrated hypomethylation in target genes regulating interferon-γ (IFN-γ), T-cell receptor signaling, and EOMES (eomesodermin), a master transcriptional regulator of cytotoxic effector cells."
explanation: >-
This supports a DNMT3A-linked epigenetic and cytotoxic differentiation
program within the PTCL-NOS branch.
- name: Immune-checkpoint-rich tumor microenvironment
description: >-
Nodal PTCL frequently develops in a suppressive immune microenvironment
enriched for regulatory T cells, exhausted CD8-positive T cells, and
druggable checkpoint programs.
cell_types:
- preferred_term: regulatory T cell
term:
id: CL:0000815
label: regulatory T cell
- preferred_term: exhausted T cell
term:
id: CL:0011025
label: exhausted T cell
biological_processes:
- preferred_term: negative regulation of immune response
modifier: INCREASED
term:
id: GO:0050777
label: negative regulation of immune response
evidence:
- reference: PMID:38813724
reference_title: "Deep phenotyping of nodal T-cell lymphomas reveals immune alterations and therapeutic targets."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The PTCL TME contained a larger proportion of regulatory T cells and exhausted CD8+ T cells, with enriched expression of druggable immune checkpoints."
explanation: >-
This supports a suppressive, checkpoint-rich tumor microenvironment as a
distinct pathophysiologic feature of nodal PTCL.
histopathology:
- name: PTCL family morphology
finding_term:
preferred_term: peripheral T-cell lymphoma family
term:
id: NCIT:C3468
label: Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma
description: >-
Family-level NCIT anchor for the mature T-cell lymphoma spectrum curated on
this page.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells."
explanation: >-
This supports the family-level histopathologic placement of PTCL among
mature T-cell lymphomas.
- name: PTCL-NOS architecture effacement
subtype: PTCL-NOS
finding_term:
preferred_term: peripheral T-cell lymphoma, not otherwise specified
term:
id: NCIT:C4340
label: Peripheral T-Cell Lymphoma, Not Otherwise Specified
description: >-
PTCL-NOS typically shows paracortical or diffuse infiltrates with
architectural effacement and a variable inflammatory background.
evidence:
- reference: PMID:20702104
reference_title: "Peripheral T-cell lymphoma--not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "In the lymph node, PTCL-NOS shows paracortical or diffuse infiltrates with effacement of the normal architecture, with a broad cytological spectrum and a frequently observed inflammatory background."
explanation: >-
This directly supports the characteristic PTCL-NOS nodal morphology.
- name: TFH lymphoma, angioimmunoblastic-type
subtype: TFH Angioimmunoblastic-Type
finding_term:
preferred_term: follicular helper T-cell lymphoma, angioimmunoblastic-type
term:
id: NCIT:C7528
label: Follicular Helper T-Cell Lymphoma, Angioimmunoblastic-Type
description: NCIT subtype anchor for angioimmunoblastic-type nodal TFH lymphoma.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This supports the angioimmunoblastic-type TFH lymphoma subtype assignment.
- name: TFH lymphoma, follicular-type
subtype: TFH Follicular-Type
finding_term:
preferred_term: follicular helper T-cell lymphoma, follicular-type
term:
id: NCIT:C80375
label: Follicular Helper T-Cell Lymphoma, Follicular-Type
description: NCIT subtype anchor for follicular-type nodal TFH lymphoma.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This supports the follicular-type TFH lymphoma subtype assignment.
- name: TFH lymphoma, NOS
subtype: TFH NOS
finding_term:
preferred_term: follicular helper T-cell lymphoma, not otherwise specified
term:
id: NCIT:C139011
label: Follicular Helper T-Cell Lymphoma, Not Otherwise Specified
description: NCIT subtype anchor for TFH lymphoma, NOS.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Three main subtypes of nodal TFH lymphomas have been described: 1) angioimmunoblastic-type, 2) follicular-type, and 3) not otherwise specified (NOS)."
explanation: >-
This supports the TFH lymphoma, NOS subtype assignment.
- name: Systemic ALCL, ALK-positive
subtype: ALK-Positive ALCL
finding_term:
preferred_term: systemic anaplastic large cell lymphoma, ALK-positive
term:
id: NCIT:C37195
label: Systemic Anaplastic Large Cell Lymphoma, ALK-Positive
description: NCIT subtype anchor for systemic ALK-positive ALCL within the PTCL family.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified."
explanation: >-
This supports ALK-positive systemic ALCL as a core PTCL subtype.
- name: Systemic ALCL, ALK-negative
subtype: ALK-Negative ALCL
finding_term:
preferred_term: systemic anaplastic large cell lymphoma, ALK-negative
term:
id: NCIT:C37196
label: Systemic Anaplastic Large Cell Lymphoma, ALK-Negative
description: NCIT subtype anchor for systemic ALK-negative ALCL within the PTCL family.
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Nodal PTCLs include ALK-positive and ALK-negative anaplastic large cell lymphoma; nodal T-cell lymphoma with T follicular helper cell origin; and PTCL, not otherwise specified."
explanation: >-
This supports ALK-negative systemic ALCL as a core PTCL subtype.
phenotypes:
- category: Lymphatic
name: Lymphadenopathy
description: >-
Lymph node enlargement is the dominant presenting pattern across the nodal
and systemic PTCL family.
phenotype_term:
preferred_term: Lymphadenopathy
term:
id: HP:0002716
label: Lymphadenopathy
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The most frequent primary sites of PTCLs are lymph nodes, with over half of cases showing nodal presentation."
explanation: >-
This supports lymph node enlargement as the dominant clinical presentation
across nodal and systemic PTCL.
- category: Constitutional
name: Fever
subtype: PTCL-NOS
description: Fever is part of the B-symptom complex frequently reported in PTCL-NOS.
phenotype_term:
preferred_term: Fever
term:
id: HP:0001945
label: Fever
evidence:
- reference: PMID:29302559
reference_title: "Peripheral T-cell lymphoma, not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Patients can experience night sweats, fever, lymphadenopathy, weight loss, splenomegaly, and/or skin changes."
explanation: >-
This review abstract explicitly lists fever among the common PTCL-NOS
clinical features.
- category: Constitutional
name: Night Sweats
subtype: PTCL-NOS
description: Night sweats are part of the systemic B-symptom complex in PTCL-NOS.
phenotype_term:
preferred_term: Night sweats
term:
id: HP:0030166
label: Night sweats
evidence:
- reference: PMID:29302559
reference_title: "Peripheral T-cell lymphoma, not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Patients can experience night sweats, fever, lymphadenopathy, weight loss, splenomegaly, and/or skin changes."
explanation: >-
This review abstract explicitly lists night sweats among the common
PTCL-NOS clinical features.
- category: Constitutional
name: Weight Loss
subtype: PTCL-NOS
description: Unintentional weight loss is a common systemic symptom in PTCL-NOS.
phenotype_term:
preferred_term: Weight loss
term:
id: HP:0001824
label: Weight loss
evidence:
- reference: PMID:29302559
reference_title: "Peripheral T-cell lymphoma, not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Patients can experience night sweats, fever, lymphadenopathy, weight loss, splenomegaly, and/or skin changes."
explanation: >-
This review abstract explicitly lists weight loss among the common
PTCL-NOS clinical features.
- category: Abdominal
name: Splenomegaly
subtype: PTCL-NOS
description: Splenic enlargement can accompany disseminated PTCL-NOS.
phenotype_term:
preferred_term: Splenomegaly
term:
id: HP:0001744
label: Splenomegaly
evidence:
- reference: PMID:29302559
reference_title: "Peripheral T-cell lymphoma, not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Patients can experience night sweats, fever, lymphadenopathy, weight loss, splenomegaly, and/or skin changes."
explanation: >-
This review abstract explicitly lists splenomegaly among the common
PTCL-NOS clinical features.
- category: Hematologic
name: Anemia
subtype: PTCL-NOS
description: Anemia is a common laboratory abnormality in PTCL-NOS.
phenotype_term:
preferred_term: Anemia
term:
id: HP:0001903
label: Anemia
evidence:
- reference: PMID:29302559
reference_title: "Peripheral T-cell lymphoma, not otherwise specified."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Common laboratory tests reveal that patients have anemia, thrombocytosis, lymphocytosis, eosinophilia, hypergammaglobulinemia, or increased lactate dehydrogenase."
explanation: >-
This review abstract explicitly identifies anemia as a common PTCL-NOS
laboratory abnormality.
biochemical:
- name: TFH Immunophenotype
notes: >-
Nodal TFH lymphomas are typically identified with a TFH-marker panel that
includes PD-1, CXCL13, CXCR5, ICOS, BCL6, and CD10.
- name: Aberrant Pan-T-cell Antigen Loss
notes: >-
PTCL-NOS frequently shows an aberrant T-cell phenotype with loss of CD5
and CD7, most often with a CD4-positive phenotype in nodal disease.
- name: CD30 Expression
notes: >-
CD30 expression identifies the PTCL subset eligible for frontline
brentuximab vedotin plus CHP and is especially relevant in systemic ALCL.
genetic:
- name: TET2
association: Recurrent Somatic Mutation
subtype: TFH Angioimmunoblastic-Type
gene_term:
preferred_term: TET2
term:
id: hgnc:25941
label: TET2
notes: >-
TET2 mutations are among the most frequent lesions in PTCL and are
especially enriched in angioimmunoblastic-type and other nodal TFH
lymphomas.
evidence:
- reference: PMID:37841428
reference_title: "Biological insights into the role of TET2 in T cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Mutations in the epigenetic regulator TET2 are among the most frequent mutations identified in PTCL, with the highest frequency in angioimmunoblastic T cell lymphomas and other nodal T follicular helper (TFH) lymphomas."
explanation: >-
This supports TET2 as a recurrent, TFH-enriched somatic lesion in PTCL.
- name: DNMT3A
association: Recurrent Somatic Mutation
subtype: PTCL-NOS
gene_term:
preferred_term: DNMT3A
term:
id: hgnc:2978
label: DNMT3A
notes: >-
DNMT3A mutations define a biologically distinct PTCL-TBX21 subset within
PTCL-NOS that is linked to cytotoxic differentiation programs and worse
outcome.
evidence:
- reference: PMID:35639959
reference_title: "DNMT3A mutations define a unique biological and prognostic subgroup associated with cytotoxic T cells in PTCL-NOS."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "DNMT3A-mutated PTCL-TBX21 cases showed inferior overall survival (OS), with DNMT3A-mutated residues skewed toward the methyltransferase domain and dimerization motif (S881-R887)."
explanation: >-
This supports DNMT3A mutation as a defining lesion of a prognostically
distinct PTCL-NOS subgroup.
- name: IDH2
association: Recurrent Somatic Mutation
subtype: TFH Angioimmunoblastic-Type
gene_term:
preferred_term: IDH2
term:
id: hgnc:5383
label: IDH2
notes: >-
IDH2 mutations are part of the characteristic TFH-lymphoma mutational
landscape and commonly co-occur with TET2 and DNMT3A lesions.
evidence:
- reference: PMID:36793612
reference_title: "Pathologic and molecular insights in nodal T-follicular helper cell lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "These neoplasms feature a characteristic and similar, but not identical, mutational landscape with mutations in epigenetic modifiers (TET2, DNMT3A, IDH2), RHOA, and T-cell receptor signaling genes."
explanation: >-
This supports IDH2 as a recurrent component of the nodal TFH lymphoma
mutational program.
- name: RHOA
association: Hotspot G17V Mutation
subtype: TFH Angioimmunoblastic-Type
gene_term:
preferred_term: RHOA
term:
id: hgnc:667
label: RHOA
notes: >-
RHOA G17V is a recurrent hotspot lesion in angioimmunoblastic-type PTCL and
rewires proximal T-cell receptor signaling through VAV1.
evidence:
- reference: PMID:28832024
reference_title: "Activation of RHOA-VAV1 signaling in angioimmunoblastic T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Somatic G17V RHOA mutations were found in 50-70% of angioimmunoblastic T-cell lymphoma (AITL)."
explanation: >-
This supports RHOA G17V as a recurrent hotspot mutation in the
angioimmunoblastic PTCL branch.
- name: VAV1
association: Activating Mutation or Fusion
subtype: TFH Angioimmunoblastic-Type
gene_term:
preferred_term: VAV1
term:
id: hgnc:12657
label: VAV1
notes: >-
VAV1 mutations and fusions define a complementary mechanism for proximal
T-cell receptor pathway activation in RHOA-wildtype angioimmunoblastic PTCL.
evidence:
- reference: PMID:28832024
reference_title: "Activation of RHOA-VAV1 signaling in angioimmunoblastic T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We further identified VAV1 mutations and a new translocation, VAV1-STAP2, in seven of the 85 RHOA mutation-negative samples (8.2%), whereas none of the 41 RHOA mutation-positive samples exhibited VAV1 mutations."
explanation: >-
This supports VAV1 mutations and fusions as alternative TCR-pathway lesions
in angioimmunoblastic-type PTCL.
- name: STAT3
association: Copy Number Gain / Pathway Activation
subtype: PTCL-NOS
gene_term:
preferred_term: STAT3
term:
id: hgnc:11364
label: STAT3
notes: >-
PTCL-GATA3 frequently acquires STAT3 gains or amplifications alongside other
proliferative pathway lesions.
evidence:
- reference: PMID:30782609
reference_title: "Genetic drivers of oncogenic pathways in molecular subgroups of peripheral T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Co-occurring gains/amplifications of STAT3 and MYC occurred in PTCL-GATA3."
explanation: >-
This supports STAT3 pathway activation as a recurrent feature of the
PTCL-GATA3 PTCL-NOS program.
treatments:
- name: CHOP-based Multiagent Chemotherapy
description: >-
Anthracycline-based combination chemotherapy remains the historic frontline
backbone for many PTCL cases, although durability is limited.
treatment_term:
preferred_term: chemotherapy
term:
id: MAXO:0000647
label: chemotherapy
evidence:
- reference: PMID:30914464
reference_title: "FDA Approval Summary: Brentuximab Vedotin in First-Line Treatment of Peripheral T-Cell Lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Improvement in progression-free and overall survival over cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy, which has been the standard of care for decades, is unprecedented."
explanation: >-
This approval summary confirms CHOP-like anthracycline chemotherapy as the
longstanding frontline standard for PTCL.
- name: Brentuximab Vedotin Plus CHP
description: >-
Frontline regimen for CD30-expressing PTCL, especially systemic ALCL and
selected PTCL-NOS and TFH cases with CD30 expression.
treatment_term:
preferred_term: chemotherapy
term:
id: MAXO:0000647
label: chemotherapy
therapeutic_agent:
- preferred_term: brentuximab vedotin
term:
id: NCIT:C66944
label: Brentuximab Vedotin
evidence:
- reference: PMID:30914464
reference_title: "FDA Approval Summary: Brentuximab Vedotin in First-Line Treatment of Peripheral T-Cell Lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The median PFS was 48.2 months with BV+CHP versus 20.8 months with CHOP"
explanation: >-
This directly supports improved frontline progression-free survival with
brentuximab vedotin plus CHP in CD30-expressing PTCL.
- reference: PMID:30914464
reference_title: "FDA Approval Summary: Brentuximab Vedotin in First-Line Treatment of Peripheral T-Cell Lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The trial also demonstrated improvement in overall survival (HR 0.66; 95% CI: 0.46-0.95), complete response rate (68% vs. 56%), and overall response rate (83% vs. 72%) with BV+CHP."
explanation: >-
This supports a broad frontline efficacy advantage for BV+CHP over CHOP.
- name: Pralatrexate
description: >-
Antifolate therapy used in relapsed or refractory PTCL after prior systemic
treatment.
treatment_term:
preferred_term: pharmacotherapy
term:
id: MAXO:0000058
label: pharmacotherapy
therapeutic_agent:
- preferred_term: pralatrexate
term:
id: NCIT:C2250
label: Pralatrexate
evidence:
- reference: PMID:21245435
reference_title: "Pralatrexate in patients with relapsed or refractory peripheral T-cell lymphoma: results from the pivotal PROPEL study."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The response rate in 109 evaluable patients was 29% (32 of 109), including 12 complete responses (11%) and 20 partial responses (18%), with a median DoR of 10.1 months."
explanation: >-
This pivotal study supports pralatrexate as an active salvage therapy in
relapsed or refractory PTCL.
- name: Romidepsin
description: >-
Histone deacetylase inhibitor with single-agent activity in relapsed PTCL.
treatment_term:
preferred_term: pharmacotherapy
term:
id: MAXO:0000058
label: pharmacotherapy
therapeutic_agent:
- preferred_term: romidepsin
term:
id: NCIT:C1544
label: Romidepsin
evidence:
- reference: PMID:21355097
reference_title: "Phase 2 trial of romidepsin in patients with peripheral T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Complete responses were observed in 8 and partial responses in 9 of 45 patients, for an overall response rate of 38% (95% confidence interval 24%-53%)."
explanation: >-
This phase 2 study supports romidepsin as an active salvage therapy in
relapsed PTCL.
- reference: PMID:21355097
reference_title: "Phase 2 trial of romidepsin in patients with peripheral T-cell lymphoma."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "The histone deacetylase inhibitor romidepsin has single agent clinical activity associated with durable responses in patients with relapsed PTCL."
explanation: >-
This supports the durability of romidepsin responses in relapsed PTCL.
- name: Autologous Hematopoietic Stem Cell Transplantation
description: >-
Consolidative transplant strategy considered in fit patients with responsive
disease, particularly in first remission or chemosensitive relapse.
treatment_term:
preferred_term: autologous hematopoietic stem cell transplantation
term:
id: NCIT:C16039
label: Autologous Hematopoietic Stem Cell Transplantation
evidence:
- reference: PMID:20359581
reference_title: "High-dose therapy and stem cell transplantation."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Studies show that autologous transplant is feasible in relapsed and previously untreated patients, and efficacy is comparable to results in aggressive B-cell lymphomas."
explanation: >-
This review supports autologous transplantation as a feasible PTCL
consolidation strategy.
- name: Allogeneic Hematopoietic Stem Cell Transplantation
description: >-
Allogeneic transplantation remains an option for selected relapsed PTCL
cases, particularly when graft-versus-lymphoma activity is sought.
treatment_term:
preferred_term: allogeneic hematopoietic stem cell transplantation
term:
id: NCIT:C46089
label: Allogeneic Hematopoietic Stem Cell Transplantation
evidence:
- reference: PMID:20359581
reference_title: "High-dose therapy and stem cell transplantation."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Allogeneic transplant may also have a role in relapsed PTCL, especially in the context of reduced-intensity conditioning, which has decreased nonrelapse mortality."
explanation: >-
This review supports an allogeneic transplant option in selected relapsed
PTCL.
mappings:
mondo_mappings:
- term:
id: MONDO:0015760
label: T-cell non-Hodgkin lymphoma
mapping_predicate: skos:closeMatch
mapping_source: MONDO
mapping_justification: >-
MONDO does not currently provide an exact family-level peripheral T-cell
lymphoma umbrella term. This entry therefore anchors to the closest MONDO
T-cell non-Hodgkin lymphoma family class, while the PTCL-specific histology
axis is carried by flat subtype facets and NCIT-grounded histopathology.
classifications:
icdo_morphology:
classification_value: Lymphoma
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells."
explanation: >-
This supports classifying PTCL within lymphoma morphology.
harrisons_chapter:
- classification_value: cancer
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "They predominantly affect adults and elderly people and usually exhibit an aggressive clinical course with poor prognosis."
explanation: >-
PTCL is an aggressive malignant neoplasm and belongs within the cancer
chapter framework.
- classification_value: hematologic malignancy
evidence:
- reference: PMID:36010351
reference_title: "Pathological and Molecular Features of Nodal Peripheral T-Cell Lymphomas."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "Peripheral T-cell lymphomas (PTCLs) are uncommon neoplasms derived from mature T cells or NK cells."
explanation: >-
This supports PTCL as a hematologic malignancy.
This curation follows the cancer-entry guidance from dismech issue #1198.
Peripheral T-cell lymphoma is modeled as a family-level nodal/systemic PTCL entry with flat subtype facets rather than separate dismech pages for each histologic entity.PTCL-NOSTFH Angioimmunoblastic-TypeTFH Follicular-TypeTFH NOSALK-Positive ALCLALK-Negative ALCLdisease_term stays MONDO-first, but MONDO does not currently expose an exact family-level PTCL umbrella term. The entry therefore uses the closest MONDO family anchor, MONDO:0015760 (T-cell non-Hodgkin lymphoma), and carries oncology-specific specificity through NCIT subtype-linked histopathology and regimen/procedure terms.NCIT:C3468, C4340, C7528, C80375, C139011, C37195, C37196)NCIT:C9549, C159558, C16039, C46089)PMID:36010351PMID:31562134PMID:36793612PMID:36793612PMID:37841428PMID:28832024PMID:31562134PMID:30782609PMID:35639959PMID:38813724PMID:20702104PMID:29302559PMID:30914464PMID:21245435PMID:21355097PMID:20359581PMID:21138864PMID:38532575MONDO:0015760 T-cell non-Hodgkin lymphomaMONDO:0004964MONDO:0004977MONDO:0958095MONDO:0017602MONDO:0017603NCIT:C3468 Mature T-Cell and NK-Cell Non-Hodgkin LymphomaNCIT:C4340NCIT:C7528NCIT:C80375NCIT:C139011NCIT:C37195NCIT:C37196CL:0002038 T follicular helper cellCL:0000815 regulatory T cellCL:0011025 exhausted T cellCL:0000794 CD8-positive, alpha-beta cytotoxic T cellGO:0006325 chromatin organizationGO:0050852 T cell receptor signaling pathwayGO:0001819 positive regulation of cytokine productionGO:0045580 regulation of T cell differentiationGO:0007259 cell surface receptor signaling pathway via JAK-STATGO:0050777 negative regulation of immune responseHP:0002716 LymphadenopathyHP:0001945 FeverHP:0030166 Night sweatsHP:0001824 Weight lossHP:0001744 SplenomegalyHP:0001903 Anemia