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International Journal of Hematology

, Volume 96, Issue 5, pp 617–623 | Cite as

Cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) in the treatment of stage IE/IIE extranodal natural killer/T cell lymphoma, nasal type: 13-year follow-up in 135 patients

  • Liang Wang
  • Zhong-jun Xia
  • Hui-qiang Huang
  • Yue Lu
  • Yu-jing Zhang
Original Article

Abstract

We conducted a retrospective study of 135 patients of stage IE/IIE extranodal natural killer/T cell lymphoma, nasal type (ENKTL) treated with CHOP as induction chemotherapy to find some valuable prognostic factors and analyze the usefulness of International Prognostic Index (IPI) and Korean Prognostic Index (KPI) in predicting prognosis. Most of the patients were in the low-risk group (IPI score 0–1). Complete remission (CR) after induction chemotherapy was achieved in 31.8 % of the patients, which increased to 69.6 % after radiotherapy. The 2-, 5-, and 10-year overall survival (OS) rates were 60, 48, and 43 %, respectively. Patients with better performance status (ECOG 0-1), normal serum LDH level, without local invasiveness, low KPI scores, and IPI score of 0 had significantly better overall survival (P < 0.05) in univariate analysis. Using multivariate analysis, we identified serum LDH level, ECOG PS score and local invasiveness to be independent prognostic factors. In conclusion, ENKTL is an aggressive lymphoma that shows heterogeneity. The IPI and KPI score systems should be improved further to classify patients into different groups, and should be validated in larger prospective trials. Due to the multi-drug resistance mechanism of ENKTL, CHOP is no longer the state of art and novel drugs should be incorporated into future treatments.

Keywords

Extranodal natural killer/T cell lymphoma International Prognostic Index Korean Prognostic Index Overall survival 

Notes

Acknowledgments

We would like to thank all of the doctors of the Cancer center, Sun-Yat Sen University for allowing us to include their patients. In addition, we appreciate the cooperation of all the pathologists of the Cancer center, Sun-Yat Sen University for their support. The authors have declared no conflicts of interest, and this work did not receive any fundings.

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Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Liang Wang
    • 1
  • Zhong-jun Xia
    • 1
  • Hui-qiang Huang
    • 2
  • Yue Lu
    • 1
  • Yu-jing Zhang
    • 3
  1. 1.Department of Hematologic Oncology, State Key Laboratory of Oncology in South ChinaSun Yat-sen University Cancer CenterGuangzhouPeople’s Republic of China
  2. 2.Department of Medical OncologyState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer CenterGuangzhouPeople’s Republic of China
  3. 3.Department of Radiation OncologyState Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer CenterGuangzhouPeople’s Republic of China

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