Natural killer-cell malignancies: diagnosis and treatment

Kwong, Yok–Lam

doi:10.1038/sj.leu.2403955

Cited by 268 publications

(299 citation statements)

References 77 publications

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“…Nasal NK cell lymphoma is almost always associated with EBV [88]. Similar to Hodgkin's lymphoma, nasal NK cell lymphoma patients have increased amounts of circulating EBV DNA in the plasma or serum [89], potentially because apoptotic proliferating tumour cells release EBV DNA [90]. Before treatment, circulating EBV DNA increases from 10 5 to 10 6 copies/mL, and EBV DNA is correlated with the clinical staging and prognosis [91,92].…”

Section: Nasal Nk Cell Lymphomamentioning

confidence: 99%

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Kimura

Ito

Suzuki

et al. 2008

Reviews in Medical Virology

137

142

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Because Epstein-Barr virus (EBV) is ubiquitous and persists latently in lymphocytes, simply detecting EBV is insufficient to diagnose EBV-associated diseases. Therefore, measuring the EBV load is necessary to diagnose EBVassociated diseases and to explore EBV pathogenesis. Due to the diverse biology of EBV, the significance of measuring EBV DNA and the optimal type of specimen differ among EBV-associated diseases. Recent advances in molecular technology have enabled the EBV genome to be quantitated rapidly and accurately. Real-time polymerase chain reaction (PCR) is a rapid and reliable method to quantify DNA and is widely used not only as a diagnostic tool, but also as a management tool for EBV-associated diseases. However, each laboratory currently measures EBV load with its own ''homebrew'' system, and there is no consensus on sample type, sample preparation protocol, or assay units. The EBV real-time PCR assay system must be standardised for large-scale studies and international comparisons.

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Section: Nasal Nk Cell Lymphomamentioning

confidence: 99%

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Kimura

Ito

Suzuki

et al. 2008

Reviews in Medical Virology

137

142

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“…Several comprehensive reviews on the pathophysiology, diagnosis, clinical features, risk stratification, and prognosis of ENKL have already been published [5][6][7][8][9]. This review will focus on the evidence from prospective clinical trials for ENKL and discuss the most recommended management at present and future directions for the better management of ENKL.…”

Section: Introductionmentioning

confidence: 99%

Current and future management of NK/T-cell lymphoma based on clinical trials

Yamaguchi

2012

Int J Hematol

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Recently reported results of well-designed prospective clinical trials for extranodal NK/T-cell lymphoma, nasal type (ENKL) have rapidly changed the management of ENKL. This review will focus on the evidence obtained from prospective clinical trials for ENKL and discuss the most highly recommended current management and future directions for the better management of ENKL. For patients with nasal NK/T-cell lymphoma of stage IE or contiguous stage IIE with cervical node involvement, concurrent chemoradiotherapy with radiotherapy (RT) and a two-thirds dose of DeVIC chemotherapy is recommended as a first-line treatment. To obtain the expected clinical outcome, performing RT following the same procedure as that reported is important. For the other patients with newly diagnosed ENKL, SMILE chemotherapy is recommended as an induction therapy. The Epstein-Barr virus DNA load in peripheral blood is useful for both prognostication and monitoring during the follow-up after treatment. Other L-asparaginasecontaining chemotherapies and chemotherapies containing non-multidrug resistance-related agents and etoposide are good options for elderly patients or patients with impaired organ function. As in the cases of other aggressive lymphomas, prospective clinical trials with adequate statistical considerations should be conducted to improve the prognosis of patients with ENKL.

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“…Among these, extranodal NK/T-cell lymphoma, nasal type is the most common type and is characterized by extranodal presentation, pleomorphic cells with angioinvasion and angiodestruction, azurophillic granules, and a strong association with EBV. Extranodal NK/T-cell lymphomas are considered to originate from mature NK cells and express CD56, CD2, and cytoplasmic CD3ε , but not surface CD3, CD5, CD16 or CD57 [2,7]. Imamura et al characterized aggressive NK cell leukemia first as a catastrophic, systemic disease and more prevalent in Asians than in Caucasians [6].…”

Section: Discussionmentioning

confidence: 99%

“…The CD56 antigen is regarded as a marker of NK cell leukemia because it is consistently expressed although not specific for NK cells [7]. The etiology of NK cell neoplasm is not well understood but is considered to be strongly associated with Epstein-Barr virus (EBV).…”

Section: Introductionmentioning

confidence: 99%

A Case of Natural Killer Cell Leukemia Misdiagnosed as Tuberculous Lymphadenopathy

Lee¹,

Kim²,

Jeon³

et al. 2009

Ann Lab Med

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194Natural killer (NK) cell neoplasms are a group of rare but highly malignant tumors. We report here one case of NK cell leukemia. A 54-yr-old woman presented with a 2-month history of progressive left neck mass. Based on the positive result of tissue PCR for Mycobacterium tuberculosis, she was at first diagnosed with tuberculous lymphadenopathy. After two weeks, she developed generalized lymphadenopathy, hepatosplenomegaly, fever and anemia. Subsequent evaluation was performed including bone marrow aspiration and biopsy. Peripheral blood smear showed leukoerythroblastic features with 31% blasts. Bone marrow was packed with agranular blastoid cells, which were periodic acid-Schiff (PAS) positive and myeloperoxidase (MPO) negative. Immunophenotyping showed that these cells were positive for CD45 and HLA-DR, whereas negative for CD3, CD5, CD7, CD10, CD13, CD14, CD19, CD20, CD22, CD33, CD34, and CD61. Because of the absence of the markers of T-cell, B-cell, and myeloid lineage-specific antigens, we added CD16/56 for the immunophenotyping and the blasts were positive (94%). The tumor cells of biopsied lymph node were only positive for CD56, consistent with NK cell lymphoma. Epstein-Barr virus (EBV) was not detected by RNA in situ hybridization. Culture for M. tuberculosis was negative. Thus this patient was diagnosed with blastic NK cell lymphoma/leukemia involving bone marrow and lymph node. (Korean J Lab Med 2009;29:194-8)

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Natural killer-cell malignancies: diagnosis and treatment

Cited by 268 publications

References 77 publications

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Measuring Epstein–Barr virus (EBV) load: the significance and application for each EBV‐associated disease

Current and future management of NK/T-cell lymphoma based on clinical trials

A Case of Natural Killer Cell Leukemia Misdiagnosed as Tuberculous Lymphadenopathy

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