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异常的预处理凝血因子水平与早期结外鼻型自然杀伤/T 细胞淋巴瘤患者的不良预后相关。

Abnormal pretreatment coagulation factor levels correlate with poor prognosis in patients with early-stage extranodal nasal-type natural/killer T cell lymphoma.

机构信息

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.

出版信息

Ann Hematol. 2020 Jun;99(6):1303-1309. doi: 10.1007/s00277-020-04035-0. Epub 2020 Apr 24.

Abstract

Coagulative dysfunction is frequently observed among patients with extranodal nasal-type natural killer/T cell lymphoma (NKTCL) in our clinical practice. However, the true prognostic value of coagulation factors in patients with NKTCL has not been evaluated systemically. Data for patients with stage I/II NKTCL who were treated in the Cancer Hospital, Chinese Academy of Medical Sciences, from January 2008 to January 2019 were collected retrospectively. The patients enrolled in this study were initially diagnosed as having early-stage disease. The patients' baseline characteristics and pretreatment laboratory tests for coagulation function, including fibrinogen (FIB) and D-dimer (D-D), were reviewed and analyzed. The influence of coagulative factors on the responses and prognosis of patients with early-stage NKTCL was evaluated. Among 394 patients assessed, 154 were included in this study. Abnormal coagulation function was found in nearly half of the patients (48.1%). Univariate analysis showed that reduced complete remission (CR) was associated with elevated D-D (P = 0.001) and elevated FIB levels (P = 0.006). The D-D level was demonstrated as associated with unfavorable progression-free survival (PFS) (P = 0.003) and overall survival (OS) (P = 0.002). Multivariate analysis indicated that an elevated D-D level was an independent factor for poor clinical response (P = 0.019), PFS (P = 0.046), and OS (P = 0.024). Elevated pretreatment levels of coagulation factors, especially D-D and plasma FIB, are unfavorable predictors for clinical response, OS, and PFS in early-stage NKTCL.

摘要

在我们的临床实践中,结外鼻型自然杀伤/T 细胞淋巴瘤(NKTCL)患者常伴有凝血功能障碍。然而,凝血因子在 NKTCL 患者中的真正预后价值尚未得到系统评估。本研究回顾性分析了 2008 年 1 月至 2019 年 1 月在中国医学科学院肿瘤医院接受治疗的 I/II 期 NKTCL 患者的临床资料。入组患者均为初诊为早期疾病。分析了患者的基线特征及凝血功能的实验室检查结果,包括纤维蛋白原(FIB)和 D-二聚体(D-D)。评估了凝血因子对早期 NKTCL 患者反应和预后的影响。在评估的 394 例患者中,154 例纳入本研究。近一半的患者(48.1%)存在凝血功能异常。单因素分析显示,D-D 升高与完全缓解(CR)率降低相关(P = 0.001),FIB 水平升高与 CR 率降低相关(P = 0.006)。D-D 水平与无进展生存(PFS)(P = 0.003)和总生存(OS)(P = 0.002)有关。多因素分析表明,D-D 水平升高是临床反应不良(P = 0.019)、PFS(P = 0.046)和 OS(P = 0.024)的独立危险因素。结论:治疗前凝血因子,尤其是 D-D 和血浆 FIB 水平升高是早期 NKTCL 患者临床反应、OS 和 PFS 的不良预测因素。

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