Radiotherapy in addition to systemic therapy reduces the early mortality of angioimmunoblastic T-cell lymphoma.

[UNLABELLED] Angioimmunoblastic T-cell lymphoma (AITL) is a rare and aggressive peripheral T-cell lymphoma that is prone to early progression and recurrence and has a poor overall prognosis. Notably, early mortality (EM) and risk factors for AITL are currently unclear. We performed a retrospective analysis of AITL data from 2000 to 2021 in the Surveillance, Epidemiology, and End Results databases. Early death was defined as death within two years from the date of diagnosis. Histograms and pie charts were used to present the distribution of overall early mortality (O-EM) and lymphoma-specific early mortality (LS-EM). Cox regression model was used to screen the risk factors. Cumulative event rate curves were used to analyze the effect of treatment on EM. In total, 2,413 patients diagnosed with AITL were included in this study. Among the deceased patients, the O-EM was 46.6%, with an LS-EM of 39.7%. EM increased significantly with age, was higher among white person than among other racial groups, and was higher among males than among females. Significant independent risk factors for both O-EM and LS-EM included sex, age, SEER historic stage, radiation therapy, and chemotherapy. The combination of chemotherapy and radiotherapy can decrease O-EM and LS-EM rates in males, aged 40–69 years, and patients with localized and regional SEER historic stages. AITL demonstrates elevated EM. However, the integration of radiotherapy with chemotherapy can significantly reduce the EM among male patients aged 40–69 years with SEER historical stage as localized and regional.

[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1007/s00277-026-06796-6.