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A proposal for a prognostic index for non-nasal type natural killer/T cell lymphoma after asparaginase-based treatment

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Abstract

In the era of asparaginase-based therapy for extranodal natural killer/T cell lymphoma (ENKTL), the clinical outcomes of ENKTL have notably improved. However, as a rare subtype of ENKTL, the therapeutic effect and prognostic factors of non-nasal type ENKTL remain unclear. Thus, we performed this study to analyze the clinical characteristics and to establish a prognostic model specifically for the non-nasal disease. We performed a retrospective study of consecutive patients newly diagnosed with non-nasal type ENKTL and mainly received asparaginase-based therapy at Sun Yat-sen University Cancer Center (SYSUCC) between January 2011 and December 2019, to analyze the prognostic factors and to propose a prognostic model. We validated the prognostic model in an independent cohort. In total, 98 non-nasal type ENKTL patients were included in the training cohort. Multivariate analyses showed that prognostic factors for OS were elevated LDH levels, involvement of bone marrow and serum total protein (TP) < 60 g/L. We developed a new prognostic model named the non-nasal type ENKTL prognostic index (NPI) by grouping the prognostic factors: group 1, no risk factors; group 2, one risk factor; and group 3, two or three risk factors, which were associated with 3-year OS rates of 84.1% (95% CI, 70.9–97.2), 46.8% (27.7–65.8), and 14.9% (0–32.9), respectively (P < 0.001). These results were validated and confirmed in an independent cohort. The new model is efficient in distinguishing non-nasal-type ENKTL patients with various outcomes in the contemporary era of asparaginase-based therapy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by Guangdong Science and Technology Department under Grant 2017B020227002.

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Author notes

  1. Zegeng Chen and Xiaojie Fang contributed equally to this work.

Authors and Affiliations

  1. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, Guangzhou, China

    Zegeng Chen, Xiaojie Fang, He Huang, Zhao Wang, Meiting Chen, Quanguang Ren, Yuyi Yao, Limei Zhang, Ying Tian, Suxia Lin & Tongyu Lin

  2. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China

    Huangming Hong

  3. Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in Southern China, and Collaborative Innovation Center of Cancer Medicine, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China

    Tongyu Lin

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  1. Zegeng Chen
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  2. Xiaojie Fang
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  4. Zhao Wang
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  12. Tongyu Lin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Zegeng Chen, Xiaojie Fang and Huangming Hong. The first draft of the manuscript was written by Zegeng Chen and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tongyu Lin.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Chen, Z., Fang, X., Huang, H. et al. A proposal for a prognostic index for non-nasal type natural killer/T cell lymphoma after asparaginase-based treatment. Ann Hematol 99, 2811–2819 (2020). https://doi.org/10.1007/s00277-020-04278-x

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