Circulating Low Absolute CD4+ T Cell Counts May Predict Poor Prognosis in Extranodal NK/T-Cell Lymphoma Patients Treating with Pegaspargase-Based Chemotherapy.
Circulating Low Absolute CD4+ T Cell Counts May Predict Poor Prognosis in Extranodal NK/T-Cell Lymphoma Patients Treating with Pegaspargase-Based Chemotherapy.
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循环中低绝对 CD4( )T 细胞计数可能预示接受基于培门冬酶化疗的结外 NK/T 细胞淋巴瘤患者的不良预后
DOI：
10.4143/crt.2018.010
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发表时间：
2019-01
影响因子：
4.6
通讯作者：
Li JY
中科院分区：
文献类型：
--
作者：
Zhang YP;Zhang R;Zhu HY;Wang L;Wu YJ;Liang JH;Shi WY;Liu H;Xu W;Li JY
鼻型结外自然杀伤/T细胞淋巴瘤（ENKTL）是一种罕见的非霍奇金淋巴瘤亚型，以天冬酰胺酶为基础的方案是最好的一线治疗。关于特定循环淋巴细胞亚群在ENKTL进展中的作用的数据有限。本研究的目的是探讨ENKTL患者循环中绝对CD 4 + T细胞计数（ACD 4Cs）的临床相关性和分布。我们回顾性地检索了70例接受基于培加帕酯方案治疗的新诊断ENKTL患者的病历。计算不同组中ACD 4C作为连续参数的比较。单变量和多变量分析用于评估总生存期（OS）和无进展生存期（PFS）的预后因素。III/IV期、B症状、乳酸脱氢酶升高、单核细胞减少症、高、中、高危国际预后指数（IPI）和韩国预后指数（KPI）、高危自然杀伤淋巴瘤预后指数（PINK）和淋巴细胞减少与诊断时低ACD 4 C显著相关。中位随访时间为32个月，ACD 4C < 0.30×109/L的患者的OS较差。低ACD 4C队列的中位OS为11个月，中位PFS为5个月。两个队列之间的OS和PFS均存在显著差异。此外，多变量考克斯分析将ACD 4 C确定为OS和PFS的独立预测因子。低ACD 4C与较差的生存率相关，并可作为接受基于天冬酰胺酶方案治疗的ENKTL患者的阴性预测因子。
Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is a rare subtype of non-Hodgkin lymphoma, and asparaginase-based regimens are the best first-line treatments. Data on the role of specific circulating lymphocyte subsets in the progression of ENKTL are limited. The aim of this study was to investigate the clinical correlation and distribution of circulating absolute CD4+ T-cell counts (ACD4Cs) in ENKTL. We retrospectively searched medical records for 70 newly diagnosed ENKTL patients treated with pegaspargase-based regimens. Comparison of ACD4Cs as a continuous parameter in different groups was calculated. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS). Stage III/IV, B symptoms, elevated lactate dehydrogenase, monocytopenia, high-intermediate and high risk International Prognostic Index (IPI) and Korean Prognostic Index (KPI), high risk Prognostic Index of Natural Killer Lymphoma (PINK), and lower lymphocytes were significantly associated with low ACD4C at diagnosis. With a median follow-up time of 32 months, patients who had an ACD4C < 0.30×109/L had a worse OS. Median OS was 11 months and median PFS was 5 months in the low ACD4C cohort. There were significant differences in both OS and PFS between the two cohorts. Moreover, multivariate Cox analysis identified ACD4Cs as an independent predictor for OS and PFS. Low ACD4Cs were associated with poorer survival and could act as a negative predictor for ENKTL patients treated with asparaginase-based regimens.