Prognostic factors for mature natural killer (NK) cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type
- 22 October 2009
- journal article
- research article
- Published by Elsevier BV in Annals Of Oncology
- Vol. 21 (5), 1032-1040
- https://doi.org/10.1093/annonc/mdp418
Abstract
Background: Patients with natural killer (NK) cell neoplasms, aggressive NK cell leukemia (ANKL) and extranodal NK cell lymphoma, nasal type (ENKL), have poor outcome. Both diseases show a spectrum and the boundary of them remains unclear. The purpose of this study is to draw a prognostic model of total NK cell neoplasms. Patients and methods: We retrospectively analyzed 172 patients (22 with ANKL and 150 with ENKL). The ENKLs consisted of 123 nasal and 27 extranasal (16 cutaneous, 9 hepatosplenic, 1 intestinal and 1 nodal) lymphomas. Results: Complete remission rate for ENKL was 73% in stage I, but 15% in stage IV, which was consistent with that for ANKL (18%). The prognosis of ENKL was better than that of ANKL (median survival 10 versus 1.9 months, P < 0.0001) but was comparable when restricted to stage IV cases (4.0 months, P = 0.16). Multivariate analysis showed that four factors (non-nasal type, stage, performance status and numbers of extranodal involvement) were significant prognostic factors. Using these four variables, an NK prognostic index was successfully constructed. Four-year overall survival of patients with zero, one, two and three or four adverse factors were 55%, 33%, 15% and 6%, respectively. Conclusion: The current prognostic model successfully stratified patients with NK cell neoplasms with different outcomes.Keywords
This publication has 51 references indexed in Scilit:
- Extranodal NK/T‐cell lymphoma: diagnosis and treatment cuesHematological Oncology, 2008
- Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 yearsAnnals of Oncology, 2005
- Chromosomal abnormalities of 200 Chinese patients with non-Hodgkin's lymphoma in Taiwan: with special reference to T-cell lymphomaAnnals Of Oncology, 2004
- Leukemia and lymphoma of natural killer lineage cellsInternational Journal of Hematology, 2003
- The World Health Organization classification of malignant lymphomas in Japan: Incidence of recently recognized entitiesPathology International, 2000
- REAL classification of malignant lymphomas in the republic of koreaCancer, 1998
- Classification of natural killer (NK) cell and NK-like T-cell malignancies [editorial; comment]Blood, 1996
- Discordant CD3 expression in lymphomas when studied on frozen and paraffin sectionsHuman Pathology, 1995
- Expression of adult and fetal natural killer cell markers in sinonasal lymphomas [see comments]Blood, 1994
- Epstein-Barr virus in nasal T-cell lymphomas in patients with lethal midline granulomaThe Lancet, 1990