Lee J, Kim W S, Park Y H, Park S H, Park K W, Kang J H, Lee S S, Lee S I, Lee S-H, Kim K, Jung C W, Ahn Y C, Ko Y H, Park K
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710, Korea.
Br J Cancer. 2005 Apr 11;92(7):1226-30. doi: 10.1038/sj.bjc.6602502.
Nasal-type NK/T cell lymphoma is an increasingly recognised disease entity of aggressive clinical behaviour. The objective of this study was to investigate clinical features and treatment outcomes in patients with nasal-type NK/T cell lymphoma. From January 1991 to December 2003, 26 patients diagnosed as nasal-type NK/T cell lymphoma were included in the analysis. One half of patients presented with poor performance status (ECOG > or =2); 46% of patients were categorised as high intermediate or high-risk group according to IPI; and 46% of patients were diagnosed at advanced stage. The median survival for 26 patients with nasal-type NK/T cell lymphoma was 7.4 months (95% CI, 0.1, 16.9). The treatment outcome of primary anthracycline-based chemotherapy was poor: 60% CR rate in localised disease and 0% CR rate in advanced disease. After a median follow-up of 24.4 months (range 3.1-99.0) in patients with localised disease who had achieved a CR (range 29.6-165.7), three patients (50.0%) developed disease recurrence at 6.1, 21.8, and 52.1 months, respectively, and all patients presented with locoregional failure. The predictive factors for poor survival were of age greater than 60, advanced stage and poor performance in multivariate analysis. In conclusion, Nasal-type NK/T cell lymphomas showed a poor response to the conventional anthracycline-based chemotherapy, and thus an investigation for an innovative therapy is urgently needed to improve survival in these patients.
鼻型NK/T细胞淋巴瘤是一种临床侵袭性行为日益受到认可的疾病实体。本研究的目的是调查鼻型NK/T细胞淋巴瘤患者的临床特征和治疗结果。1991年1月至2003年12月,26例被诊断为鼻型NK/T细胞淋巴瘤的患者纳入分析。一半患者表现为体能状态差(东部肿瘤协作组体能状态评分≥2分);46%的患者根据国际预后指数被归类为高中危或高危组;46%的患者在晚期被诊断。26例鼻型NK/T细胞淋巴瘤患者的中位生存期为7.4个月(95%可信区间,0.1,16.9)。以蒽环类药物为主的一线化疗的治疗效果较差:局限性疾病的完全缓解率为60%,晚期疾病的完全缓解率为0%。在局限性疾病且达到完全缓解的患者(范围29.6 - 165.7个月)中,中位随访24.4个月(范围3.1 - 99.0个月)后,3例患者(50.0%)分别在6.1、21.8和52.1个月出现疾病复发,所有患者均表现为局部区域复发。多因素分析显示,生存预后差的预测因素为年龄大于60岁、晚期和体能状态差。总之,鼻型NK/T细胞淋巴瘤对传统的以蒽环类药物为主的化疗反应较差,因此迫切需要研究创新疗法以提高这些患者的生存率。