Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Ann Hematol. 2020 Dec;99(12):2811-2819. doi: 10.1007/s00277-020-04278-x. Epub 2020 Sep 25.
In the era of asparaginase-based therapy for extranodal natural killer/T cell lymphoma (ENKTL), the clinical outcomes of ENKTL have notably improved. However, as a rare subtype of ENKTL, the therapeutic effect and prognostic factors of non-nasal type ENKTL remain unclear. Thus, we performed this study to analyze the clinical characteristics and to establish a prognostic model specifically for the non-nasal disease. We performed a retrospective study of consecutive patients newly diagnosed with non-nasal type ENKTL and mainly received asparaginase-based therapy at Sun Yat-sen University Cancer Center (SYSUCC) between January 2011 and December 2019, to analyze the prognostic factors and to propose a prognostic model. We validated the prognostic model in an independent cohort. In total, 98 non-nasal type ENKTL patients were included in the training cohort. Multivariate analyses showed that prognostic factors for OS were elevated LDH levels, involvement of bone marrow and serum total protein (TP) < 60 g/L. We developed a new prognostic model named the non-nasal type ENKTL prognostic index (NPI) by grouping the prognostic factors: group 1, no risk factors; group 2, one risk factor; and group 3, two or three risk factors, which were associated with 3-year OS rates of 84.1% (95% CI, 70.9-97.2), 46.8% (27.7-65.8), and 14.9% (0-32.9), respectively (P < 0.001). These results were validated and confirmed in an independent cohort. The new model is efficient in distinguishing non-nasal-type ENKTL patients with various outcomes in the contemporary era of asparaginase-based therapy.
在基于天冬酰胺酶的治疗时代，结外 NK/T 细胞淋巴瘤（ENKTL）的临床结果显著改善。然而，作为 ENKTL 的一种罕见亚型，非鼻型 ENKTL 的治疗效果和预后因素仍不清楚。因此，我们进行了这项研究，以分析临床特征并建立专门针对非鼻疾病的预后模型。我们对中山大学肿瘤防治中心（SYSUCC）于 2011 年 1 月至 2019 年 12 月期间连续收治的新诊断为非鼻型 ENKTL 且主要接受基于天冬酰胺酶治疗的患者进行了回顾性研究，以分析预后因素并提出预后模型。我们在独立队列中验证了该预后模型。共有 98 名非鼻型 ENKTL 患者纳入训练队列。多因素分析表明，OS 的预后因素包括升高的 LDH 水平、骨髓受累和血清总蛋白（TP）<60g/L。我们通过对预后因素进行分组，建立了一个新的预后模型，命名为非鼻型 ENKTL 预后指数（NPI）：组 1，无危险因素；组 2，一个危险因素；组 3，两个或三个危险因素，与 3 年 OS 率分别为 84.1%（95%CI，70.9-97.2）、46.8%（27.7-65.8）和 14.9%（0-32.9）相关（P<0.001）。这些结果在独立队列中得到了验证和确认。在基于天冬酰胺酶的治疗的当代时代，新模型在区分具有不同结局的非鼻型 ENKTL 患者方面非常有效。
