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Published in: Annals of Hematology 9/2014

01-09-2014 | Original Article

New prognostic model for extranodal natural killer/T cell lymphoma, nasal type

Authors: Qingqing Cai, Xiaolin Luo, Guanrong Zhang, Huiqiang Huang, Hui Huang, Tongyu Lin, Wenqi Jiang, Zhongjun Xia, Ken H. Young

Published in: Annals of Hematology | Issue 9/2014

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Abstract

Extranodal natural killer/T cell lymphoma, nasal type (ENKTL) is an aggressive disease with a poor prognosis, requiring risk stratification in affected patients. We designed a new prognostic model specifically for ENKTL to identify high-risk patients who need more aggressive therapy. We retrospectively reviewed 158 patients who were newly diagnosed with ENKTL. The estimated 5-year overall survival rate was 39.4 %. Independent prognostic factors included total protein (TP) <60 g/L, fasting blood glucose (FBG) >100 mg/dL, and Korean Prognostic Index (KPI) score ≥2. We constructed a new prognostic model by combining these prognostic factors: group 1 (64 cases (41.0 %)), no adverse factors; group 2 (58 cases (37.2 %)), one adverse factor; and group 3 (34 cases (21.8 %)), two or three adverse factors. The 5-year overall survival (OS) rates of these groups were 66.7, 23.0, and 5.9 %, respectively (p < 0.001). Our new prognostic model had a better prognostic value than did the KPI model alone (p < 0.001). Our proposed prognostic model for ENKTL, including the newly identified prognostic indicators, TP and FBG, demonstrated a balanced distribution of patients into different risk groups with better prognostic discrimination compared with the KPI model alone.
Literature
1.
go back to reference Jaffe ES, Chan JK, Su IJ, Frizzera G, Mori S, Feller AC, Ho FC (1996) Report of the workshop on nasal and related extranodal angiocentric T/Natural killer cell lymphomas. Definitions, differential diagnosis, and epidemiology. Am J Surg Pathol 20(1):103–111PubMedCrossRef Jaffe ES, Chan JK, Su IJ, Frizzera G, Mori S, Feller AC, Ho FC (1996) Report of the workshop on nasal and related extranodal angiocentric T/Natural killer cell lymphomas. Definitions, differential diagnosis, and epidemiology. Am J Surg Pathol 20(1):103–111PubMedCrossRef
2.
go back to reference Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD (1999) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting—Airlie House, Virginia, November 1997. J Clin Oncol 17(12):3835–3849PubMed Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD (1999) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee Meeting—Airlie House, Virginia, November 1997. J Clin Oncol 17(12):3835–3849PubMed
6.
go back to reference Guo H-Q, Huang G-L, Guo C-C, Pu X-X, Lin T-Y (2010) Diagnostic and prognostic value of circulating miR-221 for extranodal natural killer/T-cell lymphoma. Dis Markers 29(5):251–258PubMedCentralPubMedCrossRef Guo H-Q, Huang G-L, Guo C-C, Pu X-X, Lin T-Y (2010) Diagnostic and prognostic value of circulating miR-221 for extranodal natural killer/T-cell lymphoma. Dis Markers 29(5):251–258PubMedCentralPubMedCrossRef
7.
go back to reference Al-Hakeem DA, Fedele S, Carlos R, Porter S (2007) Extranodal NK/T-cell lymphoma, nasal type. Oral Oncol 43(1):4–14PubMedCrossRef Al-Hakeem DA, Fedele S, Carlos R, Porter S (2007) Extranodal NK/T-cell lymphoma, nasal type. Oral Oncol 43(1):4–14PubMedCrossRef
9.
go back to reference Cheung MM, Chan JK, Lau WH, Ngan RK, Foo WW (2002) Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality. Int J Radiat Oncol Biol Phys 54(1):182–190PubMedCrossRef Cheung MM, Chan JK, Lau WH, Ngan RK, Foo WW (2002) Early stage nasal NK/T-cell lymphoma: clinical outcome, prognostic factors, and the effect of treatment modality. Int J Radiat Oncol Biol Phys 54(1):182–190PubMedCrossRef
10.
go back to reference Chim CS, Ma SY, Au WY, Choy C, Lie AK, Liang R, Yau CC, Kwong YL (2004) Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index. Blood 103(1):216–221. doi:10.1182/blood-2003-05-1401 PubMedCrossRef Chim CS, Ma SY, Au WY, Choy C, Lie AK, Liang R, Yau CC, Kwong YL (2004) Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index. Blood 103(1):216–221. doi:10.​1182/​blood-2003-05-1401 PubMedCrossRef
11.
go back to reference Au WY, Weisenburger DD, Intragumtornchai T, Nakamura S, Kim WS, Sng I, Vose J, Armitage JO, Liang R, Pro IPT-CL (2009) Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project. Blood 113(17):3931–3937. doi:10.1182/blood-2008-10-185256 PubMedCrossRef Au WY, Weisenburger DD, Intragumtornchai T, Nakamura S, Kim WS, Sng I, Vose J, Armitage JO, Liang R, Pro IPT-CL (2009) Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project. Blood 113(17):3931–3937. doi:10.​1182/​blood-2008-10-185256 PubMedCrossRef
12.
go back to reference Kim TM, Park YH, Lee S-Y, Kim J-H, Kim D-W, Im S-A, Kim T-Y, Kim CW, Heo DS, Bang Y-J, Chang K-H, Kim NK (2005) Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage I(E)/II(E) extranodal NK/T-cell lymphoma, nasal type. Blood 106(12):3785–3790PubMedCrossRef Kim TM, Park YH, Lee S-Y, Kim J-H, Kim D-W, Im S-A, Kim T-Y, Kim CW, Heo DS, Bang Y-J, Chang K-H, Kim NK (2005) Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage I(E)/II(E) extranodal NK/T-cell lymphoma, nasal type. Blood 106(12):3785–3790PubMedCrossRef
13.
go back to reference Oshimi K, Kawa K, Nakamura S, Suzuki R, Suzumiya J, Yamaguchi M, Kameoka J, Tagawa S, Imamura N, Ohshima K, Kojya S, Iwatsuki K, Tokura Y, Sato E, Sugimori H, Grp N-CTS (2005) NK-cell neoplasms in Japan. Hematology 10(3):237–245. doi:10.1080/10245330400026162 PubMedCrossRef Oshimi K, Kawa K, Nakamura S, Suzuki R, Suzumiya J, Yamaguchi M, Kameoka J, Tagawa S, Imamura N, Ohshima K, Kojya S, Iwatsuki K, Tokura Y, Sato E, Sugimori H, Grp N-CTS (2005) NK-cell neoplasms in Japan. Hematology 10(3):237–245. doi:10.​1080/​1024533040002616​2 PubMedCrossRef
14.
go back to reference Lee J, Suh C, Park YH, Ko YH, Bang SM, Lee JH, Lee DH, Huh J, Oh SY, Kwon H-C, Kim HJ, Lee SI, Kim JH, Park J, Oh SJ, Kim K, Jung C, Park K, Kim WS (2006) Extranodal natural killer T-cell lymphoma, nasal-type: a prognostic model from a retrospective multicenter study. J Clin Oncol 24(4):612–618PubMedCrossRef Lee J, Suh C, Park YH, Ko YH, Bang SM, Lee JH, Lee DH, Huh J, Oh SY, Kwon H-C, Kim HJ, Lee SI, Kim JH, Park J, Oh SJ, Kim K, Jung C, Park K, Kim WS (2006) Extranodal natural killer T-cell lymphoma, nasal-type: a prognostic model from a retrospective multicenter study. J Clin Oncol 24(4):612–618PubMedCrossRef
15.
go back to reference Kim TM, Lee SY, Jeon YK, Ryoo BY, Cho GJ, Hong YS, Kim HJ, Kim SY, Kim CS, Kim S, Kim JS, Sohn SK, Song HH, Lee JL, Kang YK, Yim CY, Lee WS, Yuh YJ, Kim CW, Heo DS, Lymphoma Subcommittee of the Korean Cancer Study G (2008) Clinical heterogeneity of extranodal NK/T-cell lymphoma, nasal type: a national survey of the Korean Cancer Study Group. Ann Oncol 19(8):1477–1484PubMedCrossRef Kim TM, Lee SY, Jeon YK, Ryoo BY, Cho GJ, Hong YS, Kim HJ, Kim SY, Kim CS, Kim S, Kim JS, Sohn SK, Song HH, Lee JL, Kang YK, Yim CY, Lee WS, Yuh YJ, Kim CW, Heo DS, Lymphoma Subcommittee of the Korean Cancer Study G (2008) Clinical heterogeneity of extranodal NK/T-cell lymphoma, nasal type: a national survey of the Korean Cancer Study Group. Ann Oncol 19(8):1477–1484PubMedCrossRef
16.
go back to reference Park BB, Ryoo BY, Lee JH, Kwon HC, Yang SH, Kang HJ, Kim HJ, Oh SY, Ko YH, Huh JR, Lee SS, Nam EM, Park KW, Kim JH, Kang JH, Bang SM, Park S, Kim K, Park K, Suh C, Kim WS (2007) Clinical features and treatment outcomes of angioimmunoblastic T-cell lymphoma. Leuk Lymphoma 48(4):716–722. doi:10.1080/10428190601123989 PubMedCrossRef Park BB, Ryoo BY, Lee JH, Kwon HC, Yang SH, Kang HJ, Kim HJ, Oh SY, Ko YH, Huh JR, Lee SS, Nam EM, Park KW, Kim JH, Kang JH, Bang SM, Park S, Kim K, Park K, Suh C, Kim WS (2007) Clinical features and treatment outcomes of angioimmunoblastic T-cell lymphoma. Leuk Lymphoma 48(4):716–722. doi:10.​1080/​1042819060112398​9 PubMedCrossRef
17.
go back to reference Rodriguez J, Conde E, Gutierrez A, Arranz R, Leon A, Marin J, Bendandi M, Albo C, Caballero MD (2007) The results of consolidation with autologous stem-cell transplantation in patients with peripheral T-cell lymphoma (PTCL) in first complete remission: the Spanish Lymphoma and Autologous Transplantation Group experience. Ann Oncol 18(4):652–657. doi:10.1093/annonc/mdl466 PubMedCrossRef Rodriguez J, Conde E, Gutierrez A, Arranz R, Leon A, Marin J, Bendandi M, Albo C, Caballero MD (2007) The results of consolidation with autologous stem-cell transplantation in patients with peripheral T-cell lymphoma (PTCL) in first complete remission: the Spanish Lymphoma and Autologous Transplantation Group experience. Ann Oncol 18(4):652–657. doi:10.​1093/​annonc/​mdl466 PubMedCrossRef
19.
go back to reference Huang JJ, Jiang WQ, Lin TY, Huang Y, Xu RH, Huang HQ, Li ZM (2011) Absolute lymphocyte count is a novel prognostic indicator in extranodal natural killer/T-cell lymphoma, nasal type. Ann Oncol 22(1):149–155. doi:10.1093/annonc/mdq314 PubMedCrossRef Huang JJ, Jiang WQ, Lin TY, Huang Y, Xu RH, Huang HQ, Li ZM (2011) Absolute lymphocyte count is a novel prognostic indicator in extranodal natural killer/T-cell lymphoma, nasal type. Ann Oncol 22(1):149–155. doi:10.​1093/​annonc/​mdq314 PubMedCrossRef
21.
go back to reference Lee J, Park YH, Kim WS, Lee S-S, Ryoo B-Y, Yang SH, Park KW, Kang JH, Park JO, Lee SH, Kim K, Jung CW, Park YS, Im Y-H, Kang WK, Lee MH, Ko YH, Ahn YC, Park K (2005) Extranodal nasal type NK/T-cell lymphoma: elucidating clinical prognostic factors for risk-based stratification of therapy. Eur J Cancer 41(10):1402–1408PubMedCrossRef Lee J, Park YH, Kim WS, Lee S-S, Ryoo B-Y, Yang SH, Park KW, Kang JH, Park JO, Lee SH, Kim K, Jung CW, Park YS, Im Y-H, Kang WK, Lee MH, Ko YH, Ahn YC, Park K (2005) Extranodal nasal type NK/T-cell lymphoma: elucidating clinical prognostic factors for risk-based stratification of therapy. Eur J Cancer 41(10):1402–1408PubMedCrossRef
22.
go back to reference Kim TM, Heo DS (2009) Extranodal NK/T-cell lymphoma, nasal type: new staging system and treatment strategies. Cancer Sci 100(12):2242–2248PubMedCrossRef Kim TM, Heo DS (2009) Extranodal NK/T-cell lymphoma, nasal type: new staging system and treatment strategies. Cancer Sci 100(12):2242–2248PubMedCrossRef
23.
go back to reference Luo J, Chen Y-J, Chang L-J (2012) Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients. Lung Cancer 76(2):242–247PubMedCrossRef Luo J, Chen Y-J, Chang L-J (2012) Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients. Lung Cancer 76(2):242–247PubMedCrossRef
24.
go back to reference Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP (1999) Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17(4):1244PubMed Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP (1999) Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17(4):1244PubMed
25.
go back to reference Grillo-Lopez AJ, Cheson BD, Horning SJ, Peterson BA, Carter WD, Varns CL, Klippenstein DL, Shen CD (2000) Response criteria for NHL: importance of ‘normal’ lymph node size and correlations with response rates. Ann Oncol 11(4):399–408. doi:10.1023/A:1008332713631 PubMedCrossRef Grillo-Lopez AJ, Cheson BD, Horning SJ, Peterson BA, Carter WD, Varns CL, Klippenstein DL, Shen CD (2000) Response criteria for NHL: importance of ‘normal’ lymph node size and correlations with response rates. Ann Oncol 11(4):399–408. doi:10.​1023/​A:​1008332713631 PubMedCrossRef
26.
go back to reference Kim SJ, Kim BS, Choi CW, Choi J, Kim I, Lee YH, Kim JS (2007) Ki-67 expression is predictive of prognosis in patients with stage I/II extranodal NK/T-cell lymphoma, nasal type. Ann Oncol 18(8):1382–1387PubMedCrossRef Kim SJ, Kim BS, Choi CW, Choi J, Kim I, Lee YH, Kim JS (2007) Ki-67 expression is predictive of prognosis in patients with stage I/II extranodal NK/T-cell lymphoma, nasal type. Ann Oncol 18(8):1382–1387PubMedCrossRef
27.
go back to reference Watanabe T, Kinoshita T, Itoh K, Yoshimura K, Ogura M, Kagami Y, Yamaguchi M, Kurosawa M, Tsukasaki K, Kasai M, Tobinai K, Kaba H, Mukai K, Nakamura S, Ohshima K, Hotta T, Shimoyama M, Jcog LSG (2010) Pretreatment total serum protein is a significant prognostic factor for the outcome of patients with peripheral T/natural killer-cell lymphomas. Leuk Lymphoma 51(5):813–821. doi:10.3109/10428191003721359 PubMedCrossRef Watanabe T, Kinoshita T, Itoh K, Yoshimura K, Ogura M, Kagami Y, Yamaguchi M, Kurosawa M, Tsukasaki K, Kasai M, Tobinai K, Kaba H, Mukai K, Nakamura S, Ohshima K, Hotta T, Shimoyama M, Jcog LSG (2010) Pretreatment total serum protein is a significant prognostic factor for the outcome of patients with peripheral T/natural killer-cell lymphomas. Leuk Lymphoma 51(5):813–821. doi:10.​3109/​1042819100372135​9 PubMedCrossRef
28.
go back to reference Barone BB, Yeh HC, Snyder CF, Peairs KS, Stein KB, Derr RL, Wolff AC, Brancati FL (2008) Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus a systematic review and meta-analysis. JAMA J Am Med Assoc 300(23):2754–2764CrossRef Barone BB, Yeh HC, Snyder CF, Peairs KS, Stein KB, Derr RL, Wolff AC, Brancati FL (2008) Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus a systematic review and meta-analysis. JAMA J Am Med Assoc 300(23):2754–2764CrossRef
29.
Metadata
Title
New prognostic model for extranodal natural killer/T cell lymphoma, nasal type
Authors
Qingqing Cai
Xiaolin Luo
Guanrong Zhang
Huiqiang Huang
Hui Huang
Tongyu Lin
Wenqi Jiang
Zhongjun Xia
Ken H. Young
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 9/2014
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-014-2089-x

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