Fang Xiaojie, Zhou Fenglan, Ye Sheng, Zhang Hongyu, Guo Hongqiang, Chen Xinggui, Liang Chaoyong, Pu Xingxiang, Cao Yabing, Ren Quanguang, Li Xiaoqian, Zhai Linzhu, Huang He, Hong Huangming
Department of Medical Oncology, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu, 610042, China.
Ann Hematol. 2025 Jan;104(1):445-455. doi: 10.1007/s00277-024-06160-6. Epub 2025 Jan 8.
Advanced-stage extranodal natural killer/T-cell lymphoma (ENKTL) is a highly heterogeneous disease with very poor prognosis. All commonly utilized prognostic models incorporated both early-stage and advanced-stage patients in the modeling process. This study aim to design a prognostic model specifically for advanced-stage ENKTL, providing risk stratification in affected patients. We analyzed 291 patients with stage III/IV ENKTL receiving asparaginase-based chemotherapy from 8 institutions to develop a new prognostic model and validate it in an independent cohort consisted of 221 patients from 4 additional hospitals. The prognostic model included three independent variables based on a multivariate analysis for overall survival (OS): age, bone marrow invasiveness and visceral organ involvement. We identified three different risk groups: group 1, no adverse factors; group 2, one factor; and group 3, two or three factors, which were associated with 5-year OS rates of 66.0%, 32.3%, and 20.0%, respectively (P < 0.001). The prognostic index of natural killer lymphoma (PINK) and nomogram-revised risk index (NRI) were unsatisfactory for stratifying these patients. These results were validated and confirmed in an independent cohort. This newly proposed model can be used to guide risk-adapted treatment for advanced stage ENKTL.
晚期结外自然杀伤/T细胞淋巴瘤（ENKTL）是一种高度异质性疾病，预后很差。所有常用的预后模型在建模过程中都纳入了早期和晚期患者。本研究旨在设计一种专门针对晚期ENKTL的预后模型，为受影响患者提供风险分层。我们分析了来自8家机构的291例接受基于天冬酰胺酶化疗的III/IV期ENKTL患者，以开发一种新的预后模型，并在一个由另外4家医院的221例患者组成的独立队列中进行验证。该预后模型基于对总生存期（OS）的多变量分析包括三个独立变量：年龄、骨髓浸润和内脏器官受累。我们确定了三个不同的风险组：第1组，无不良因素；第2组，一个因素；第3组，两个或三个因素，其5年总生存率分别为66.0%、32.3%和20.0%（P < 0.001）。自然杀伤淋巴瘤预后指数（PINK）和列线图修订风险指数（NRI）对这些患者进行分层并不理想。这些结果在一个独立队列中得到了验证和证实。这个新提出的模型可用于指导晚期ENKTL的风险适应性治疗。
