When do we need central nervous system prophylaxis in patients with extranodal NK/T-cell lymphoma, nasal type?
When do we need central nervous system prophylaxis in patients with extranodal NK/T-cell lymphoma, nasal type?
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DOI：
10.1093/annonc/mdp412
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发表时间：
2010-05-01
影响因子：
50.5
通讯作者：
Kim, W. S.
中科院分区：
文献类型：
--
作者：
Kim, S. J.;Oh, S. Y.;Kim, W. S.
患者和方法：我们分析了 208 名患者，以研究结外 NK/T 细胞淋巴瘤中枢神经系统疾病的临床特征和结果。结果：12 名患者 (5.76%，12/208) 在治疗或随访期间（中位 11.62 个月，范围 0.2-123.2 个月）出现中枢神经系统疾病。与 CNS 疾病相关的临床变量为安娜堡 III/IV 期（15.87%，P < 0.001）、区域淋巴结受累（10.41%，P = 0.006）、NK/T 细胞淋巴瘤预后指数 III/IV 组（NKPI；10.20%，P = 0.003）、高/中高国际预后指数（9.30%， P = 0.072）和上上部呼吸消化原发部位（9.75%，P = 0.008）。在多变量分析中，NKPI 保留了预测结外 NK/T 细胞淋巴瘤中枢神经系统疾病的最强统计功效（P = 0.007，相对风险 9.289，95% 置信区间 1.828-47.212）。结论：尽管结外 NK/T 细胞淋巴瘤经常累及鼻旁窦，但在 NKPI 组 I 或 II 中似乎不需要进行常规 CNS 评估和预防由于发病率极低，患者。然而，NKPI III 组和 IV 组应考虑 CNS 预防。
Patients and methods: We analyzed 208 patients to study the clinical features and outcomes of CNS disease in extranodal NK/T-cell lymphoma.Results: Twelve patients (5.76%, 12/208) experienced CNS disease during treatment or follow-up period (median 11.62 months, range 0.2-123.2 months). The clinical variables associated with CNS disease were Ann Arbor stage III/IV (15.87%, P < 0.001), regional lymph node involvement (10.41%, P = 0.006), group III/IV of NK/T-cell lymphoma prognostic index (NKPI; 10.20%, P = 0.003), high/high-intermediate international prognostic index (9.30%, P = 0.072) and extra-upper aerodigestive primary sites (9.75%, P = 0.008). In multivariate analysis, NKPI retained the strongest statistical power to predict CNS disease (P = 0.007, relative risk 9.289, 95% confidence interval 1.828-47.212) in extranodal NK/T-cell lymphoma.Conclusions: Despite extranodal NK/T-cell lymphoma frequently involves paranasal sinus, a routine CNS evaluation and prophylaxis do not seem to be necessary in NKPI group I or II patients due to a very low incidence. Nevertheless, CNS prophylaxis should be considered in NKPI groups III and IV.