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      Treatments and Outcomes of Patients With Extranodal Natural Killer/T-Cell Lymphoma Diagnosed Between 2000 and 2013: A Cooperative Study in Japan.

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          Abstract

          Purpose To elucidate the management and outcomes of patients with extranodal natural killer/T-cell lymphoma, nasal type (ENKL), who were diagnosed between 2000 and 2013 in Japan. Patients and Methods Data from 358 patients with ENKL diagnosed between 2000 and 2013 from 31 institutes were retrospectively analyzed. Results Patients' median age was 58 years, and 257 (72%) had localized disease. The most common first-line treatment was radiotherapy with dexamethasone, etoposide, ifosfamide, and carboplatin (RT-DeVIC) (66%) for localized ENKL and L-asparaginase-containing chemotherapy (30%) for advanced ENKL. With a median follow-up of 5.8 years, overall survival (OS) rates at 5 years for localized and advanced ENKL were 68% and 24%, respectively. The prognostic index of natural killer lymphoma was validated in our study, although only 4% of patients with localized ENKL were classified as high risk. With a median follow-up of 5.6 years, OS and progression-free survival at 5 years in the 150 patients who received RT-DeVIC in clinical practice were 72% (95% CI, 63% to 78%) and 61% (95% CI, 52% to 69%), respectively. Toxicities of RT-DeVIC were comparable to those in a previous trial. Multivariate analysis in patients with localized ENKL who received RT-DeVIC identified elevated soluble interleukin-2 receptor as an independent predictive factor for worse OS and progression-free survival (adjusted hazard ratios, 2.28 and 2.46; 95% CI, 1.24 to 4.23 and 1.42 to 4.28; P = .008 and .0014, respectively). Conclusion Favorable OS in response to new treatments was demonstrated in a large number of patients. Improved treatment approaches are needed for localized ENKL exhibiting elevated pretreatment soluble interleukin-2 receptor.

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          Author and article information

          Journal
          J. Clin. Oncol.
          Journal of clinical oncology : official journal of the American Society of Clinical Oncology
          American Society of Clinical Oncology (ASCO)
          1527-7755
          0732-183X
          Jan 2017
          : 35
          : 1
          Affiliations
          [1 ] Motoko Yamaguchi, Kana Miyazaki, Noriko Ii, and Naoyuki Katayama, Mie University Graduate School of Medicine, Tsu; Ritsuro Suzuki, Shimane University Hospital, Izumo; Masahiko Oguchi and Kyoko Ueda, Cancer Institute Hospital of the Japanese Foundation for Cancer Research; Yukio Kobayashi and Jun Itami, National Cancer Center Hospital; Bungo Saito, Showa University School of Medicine, Tokyo; Naoko Asano, Nagano Prefectural Suzaka Hospital, Suzaka; Jun Amaki and Takeshi Akiba, Tokai University School of Medicine, Isehara; Takeshi Maeda and Satoshi Itasaka, Kurashiki Central Hospital, Kurashiki; Nobuko Kubota and Yoshihiro Saito, Saitama Cancer Center, Ina; Naoto Tomita, Yokohama City University Graduate School of Medicine, Yokohama; Nodoka Sekiguchi, Shinshu University School of Medicine, Matsumoto; Jun Takizawa, Niigata University Faculty of Medicine, Niigata; Tohru Murayama, Hyogo Cancer Center, Akashi; Toshihiko Ando, Saga University, Saga; Hideho Wada, Kawasaki Medical School, Kurashiki; Rie Hyo, Nagoya University Graduate School of Medicine, Nagoya; Yasuo Ejima, Kobe University, Kobe; and Masatoshi Hasegawa, Nara Medical University, Kashihara, Japan.
          Article
          10.1200/JCO.2016.68.1619
          10.1200/JCO.2016.68.1619
          28034070

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