Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index
Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index
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DOI：
10.1182/blood-2003-05-1401
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发表时间：
2004-01-01
期刊：
影响因子：
20.3
通讯作者：
Kwong, YL
中科院分区：
文献类型：
--
作者：
Chim, CS;Ma, SY;Kwong, YL
鼻自然杀伤（NK）细胞淋巴瘤是罕见的，因此其最佳治疗，长期结果和预后因素尚不清楚。回顾性分析了52例男性和15例女性鼻NK细胞淋巴瘤患者的资料，以确定主要治疗对缓解和长期结局的影响以及国际预后指数（IPI）的有效性。大多数（84%）患有I/II期疾病，IPI评分为1或更低（52%）。7例患者仅接受放疗; 47例患者接受含蒽环类药物的化疗加巩固放疗; 12例患者接受不含蒽环类药物的化疗加放疗。总的完全缓解率（CR）为64.2%，20年总生存率（OS）和无病生存率（DFS）分别为37.1%和33.5%。一线放疗的CR率（100%）和OS率（83.3%）明显优于化疗（59%，P = 0.04）和OS率（32.0%，P = 0.03）。复发发生在4例放疗治疗（均为局部）和14例化疗治疗患者（9例局部，4例全身）。其中，5例晚期复发（4例局部复发，1例全身复发）发生在CR后170个月（范围，92-348个月）。IPI评分对整个组的预后有意义（IPI：5 1上级于IPI：2，20年OS：57.4% vs 27.6%，P = 0.012），以及接受化疗/放疗的患者（IPI小于或等于1上级优于IPI大于或等于2，CR：76.7% vs 35.7%，P = 0.017; 10年OS：63.8% vs 26.8%，P = 0.003）。
Nasal natural killer (NK) cell lymphoma is rare, so that its optimal therapy, long-term outcome, and prognostic factors are unclear. Data on 52 men and 15 women with well-characterized nasal NK cell lymphomas were analyzed retrospectively to define the impact of primary therapy on remission and long-term outcome and the validity of the International Prognostic Index (IPI). Most (84%) had stage I/II disease with an IPI score of 1 or less (52%). Seven patients received radiotherapy only; 47 patients received anthracycline-containing chemotherapy plus consolidation radiotherapy; and 12 patients received nonanthracycline-containing chemotherapy plus radiotherapy. The overall complete remission (CR) rate was 64.2%; the 20-year overall survival (OS) and disease-free survival (DFS) rates were 37.1% and 33.5%, respectively. Front-line radiotherapy was apparently better than chemotherapy for CR (100% versus 59%, P =.04) and OS (83.3% versus 32.0%, P =.03). Relapses occurred in 4 radiotherapy-treated (all local) and 14 chemotherapy-treated patients (9 local, 4 systemic). Among these, 5 late relapses (4 local, 1 systemic) occurred at 170 months (range, 92-348 months) from CR. The IPI score was of prognostic significance for the whole group (IPI :5 1 superior to IPI : 2 for 20-year OS: 57.4% versus 27.6%, P = 0.012), as well as for patients treated with chemotherapy/radiotherapy (IPI less than or equal to 1 superior to IPI greater than or equal to 2 for CR: 76.7% versus 35.7%, P =.017; and 10-year OS: 63.8% versus 26.8%, P =.003).