改善晚期结外NK/ t细胞淋巴瘤的预后：NKEA-Next研究的结果

IF 12.8 1区医学 Q1 HEMATOLOGY

Leukemia Pub Date : 2025-02-17 DOI:10.1038/s41375-025-02527-4

Ayumi Fujimoto, Kana Miyazaki, Kimikazu Yakushijin, Takahiro Fujino, Wataru Munakata, Yasuo Ejima, Dai Maruyama, Nobuko Kubota, Takeshi Maeda, Jun Takizawa, Nobuhiro Hiramoto, Masahiro Takeuchi, Rika Sakai, Noriko Fukuhara, Senzo Taguchi, Naoko Asano, Motoko Yamaguchi, Ritsuro Suzuki

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引用次数: 0

摘要

对2014年至2021年在日本诊断的结外自然杀伤/ t细胞淋巴瘤（ENKL）患者进行了回顾性研究。在351例数据充足的患者中，116例（33%）在诊断时处于晚期（5例为III期，111例为IV期），进一步分析。中位年龄为60岁（范围：19-90岁），男性68例（59%）。94例（85%）IV期患者有两个或更多结外受累。最常见的一线方案是SMILE(类固醇、甲氨蝶呤、异环磷酰胺、l -天冬酰胺酶和依托泊苷；52%)。所有患者的2年总生存率（OS）为38.5%，2017年后显着改善(2014-2017年为25.2%，2018-2021年为50.7%；p = 0.008)。SMILE组患者的OS优于DeVIC组和CHOP组(2y-OS分别为57.1%、35.8%和0%；P < 0.001)。接受造血干细胞移植（HSCT）的患者预后明显好于未接受移植的患者（2年OS: 68.3% vs. 17.6%, P < 0.001）。多因素分析显示SMILE和HSCT是OS的显著影响因素。总之，近年来晚期ENKL的预后有所改善。含l -天冬酰胺酶的化疗和随后的造血干细胞移植被认为是推荐的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Improved prognosis of advanced-stage extranodal NK/T-cell lymphoma: results of the NKEA-Next study

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Improved prognosis of advanced-stage extranodal NK/T-cell lymphoma: results of the NKEA-Next study

A retrospective study of extranodal natural killer/T-cell lymphoma (ENKL) patients diagnosed between 2014 and 2021 in Japan was conducted. Among 351 patients with sufficient data, 116 (33%) were in the advanced stage (5 in stage III and 111 in stage IV) at diagnosis, and were further analyzed. The median age was 60 years (range: 19–90), and 68 (59%) were male. Ninety-four (85%) of stage IV patients had two or more extranodal involvements. The most common first-line regimen was SMILE (steroid, methotrexate, ifosfamide, L-asparaginase, and etoposide; 52%). The 2-year overall survival (OS) for all patients was 38.5%, which was significantly improved after 2017 (25.2% for 2014–2017 vs. 50.7% for 2018–2021; P = 0.008). Patients treated with SMILE showed better OS than those treated with DeVIC or CHOP (2y-OS: 57.1%, 35.8%, and 0%, respectively; P < 0.001). The prognosis was significantly better in patients who received hematopoietic stem cell transplantation (HSCT) than in those who did not (2-year OS: 68.3% vs. 17.6%, P < 0.001). Multivariate analysis showed SMILE and HSCT were significant factors for OS. In conclusion, the prognosis of advanced-stage ENKL has improved in recent years. The L-asparaginase-containing chemotherapy and subsequent HSCT is considered the recommended strategy.

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来源期刊

Leukemia 医学-血液学

CiteScore

18.10

自引率

3.50%

发文量

270

审稿时长

3-6 weeks

期刊介绍： Title: Leukemia Journal Overview: Publishes high-quality, peer-reviewed research Covers all aspects of research and treatment of leukemia and allied diseases Includes studies of normal hemopoiesis due to comparative relevance Topics of Interest: Oncogenes Growth factors Stem cells Leukemia genomics Cell cycle Signal transduction Molecular targets for therapy And more Content Types: Original research articles Reviews Letters Correspondence Comments elaborating on significant advances and covering topical issues