Prognostic implications of circulating Epstein&amp;ndash;Barr virus DNA for extranodal natural killer/T-cell lymphoma, nasal type: a meta-analysis

Chen, Ruiwan; Wang, Chengtao; Zhou, Yu; Wen, Bo

doi:10.2147/cmar.s162168

Cited by 6 publications

(8 citation statements)

References 43 publications

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“…Previous studies mainly focused on the involvement and prognostic value of non-immune factors in ENKTL, such as EBV DNA 31. More recently, several studies investigated the prognostic value of ALC in T-cell NHL.…”

Section: Discussionmentioning

confidence: 99%

<p>Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma</p>

Zhou

Sun

Zhao

et al. 2019

CMAR

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Background: Accumulating evidence suggested that tumor microenvironment and host immune system played important roles in determining the clinical course and outcome of human malignancies. The derived neutrophil to lymphocyte ratio (dNLR) and absolute lymphocyte count (ALC) were demonstrated to act as a prognostic factor in several malignancies. Nevertheless, the prognostic significance of them in extranodal natural killer/T-cell lymphoma (ENKTL) patients has never been explored. Patients and methods: A total of 33 newly diagnosed patients with ENKTL were included in this study. Clinicopathological characteristics were collected and prognostic significance of dNLR and ALC were evaluated. Results: Elevated dNLR and low ALC were both associated with poor survival rates. Patients with dNLR ≥3.6 revealed significantly shorter overall survival (OS) ( P =0.001) and progression-free survival (PFS) ( P =0.008) than those with dNLR <3.6. Patients with ALC <0.8×10 9 /L had worse OS ( P =0.008) and PFS ( P <0.001) than those with ALC ≥0.8×10 9 /L. An independent significant association between low ALC and poor clinical outcome in multivariate analysis for OS (HR, 36.023; 95% CI, 2.438–532.243; P =0.009) as well as PFS (HR, 7.698; 95%CI, 1.573–37.679; P =0.012) was identified. Conclusion: In this study, we validated for the first time the prognostic value of dNLR and ALC in ENKTL patients. Elevated dNLR and low ALC were both associated with aggressive tumor process and poor survival.ALC value at diagnosis represented an independent favorable prognostic factor for the clinical outcome of ENKTL patients.

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Section: Discussionmentioning

confidence: 99%

<p>Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma</p>

Zhou

Sun

Zhao

et al. 2019

CMAR

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“…Quantitative polymerase chain reaction for EBV DNA might not be available in all hospitals. In addition, the reference values, measuring procedure and sample type (whole blood or plasma) [ 21 ], and the definition of high titer is not yet standardized [ 22 ]. Because of these limitations, the PINK-E model incorporates a detectable EBV-DNA titer regardless of the sample type.…”

Section: Discussionmentioning

confidence: 99%

A New Prognostic Index for Extranodal Natural Killer/T-Cell Lymphoma:Incorporation of Serum β-2 Microglobulin to PINK

et al. 2023

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Purpose Prognostic Index for Natural Killer Lymphoma (PINK) is the most widely accepted prognostic model for patients withextranodal natural killer/T-cell lymphoma (ENKTL) treated with non-anthracycline–based therapy. We aimed to evaluate the prognostic implications of serum β-2 microglobulin (β2M) in the context of PINK and proposed a new prognostic model.Materials and Methods A total of 138 patients who were newly diagnosed with ENKTL and treated with non-anthracycline-based chemotherapy were identified. The cut-off value of high serum β2M was calculated by maximal-chi square methods (4.1 mg/L). A new prognostic model incorporating serum β2M into PINK was proposed and validated in an independent validation cohort (n=88).Results The patients’ median age was 53.5 years (range, 19 to 80 years). Patients with high serum β2M levels had significantly worse overall survival (OS) and progression-free survival (PFS). In multivariate analysis, high serum β2M was an independent adverse prognostic factor for OS. A new PINK-B (Prognostic Index for Natural Killer Lymphoma-serum β-2 microglobulin) model stratifiedpatients into three groups with distinct OS and PFS in the training cohort (3-year OS, 84.1% [95% confidence interval, 75.1 to 94.2], 46.8% [36.1 to 60.8] and 17.6% [6.3 to 49.2] for the low-, intermediate, and high-risk groups, respectively; 3-year PFS, 70.6% [59.4 to 83.8], 35.9% [25.9 to 49.8], and 7.35% [1.1 to 46.7] for the low-, intermediate-, and high-risk groups, respectively). The PINK-B model was further validated in an independent cohort.Conclusion Serum β2M is an independent prognostic factor for ENKTL patients. The new serum β2M-based prognostic model may be useful for identifying ultra-high-risk patients, and it can easily be adopted into daily clinical practice.

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“…Additionally, it has been reported that detection of circulating EBV-DNA at the end of the treatment was associated with a high relapse rate. 37 Therefore, serum EBV-DNA has been added to the risk stratification of ENKTL, and patients with high copy number of serum EBV-DNA were treated with more intensive chemotherapy. 38,39 EBV-DNA in peripheral blood can be used as a marker for the precise diagnosis and treatment, outcome evaluation, and prognosis prediction of ENKTL.…”

Section: Discussionmentioning

confidence: 99%

Comparison of chemotherapy with or without asparaginase for extranodal nasal NK/T‐cell lymphoma in children and adolescents

Zhen

Huang

Lin

et al. 2021

Pediatric Blood & Cancer

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Purpose As extranodal natural killer/T‐cell lymphoma (ENKTL) occurs rarely in children and adolescents, standardized therapy is yet to be determined. This study aimed to describe the clinical features and determine the optimal chemotherapy regimen for childhood ENKTL. Methods The treatment outcomes of radiotherapy combined with asparaginase‐based (P‐GEMOX or P‐GMED) or asparaginase‐absent chemotherapy regimens (CHOP, EPOCH, or NHL‐BFM‐90/95) in patients aged ≤18 years with newly diagnosed ENKTL from December 2006 to December 2018 were compared. Results Among the 34 patients included in the study, 21 had stage I/II disease. The overall response rates of chemotherapy with or without asparaginase were 85.0% and 78.6%, respectively. With a median follow‐up of 54 months, the 5‐year event‐free survival (EFS) rates of patients with stage I/II and III/IV disease were 66.2 ± 11.3% and 26.0 ± 12.8%, respectively (P = .027). In stage III/IV patients treated with asparaginase‐based or asparaginase‐absent regimens, the 5‐year EFS rates were 40.0 ± 17.4% and 0%, respectively (P = .236). The 5‐year EFS rates of stage III/IV patients who received or did not receive hematopoietic stem cell transplant were 66.7 ± 27.2% and 11.1 ± 10.5%, respectively (P = .054). In addition, chemotherapy‐associated side effects were significantly less in patients treated with asparaginase‐based regimens as compared to asparaginase‐absent regimens in this cohort. Conclusion P‐GEMOX and P‐GMED regimens are effective and safe for treating childhood ENKTL.

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Prognostic implications of circulating Epstein–Barr virus DNA for extranodal natural killer/T-cell lymphoma, nasal type: a meta-analysis

Cited by 6 publications

References 43 publications

<p>Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma</p>

<p>Prognostic significance of peripheral blood absolute lymphocyte count and derived neutrophil to lymphocyte ratio in patients with newly diagnosed extranodal natural killer/T-cell lymphoma</p>

A New Prognostic Index for Extranodal Natural Killer/T-Cell Lymphoma:Incorporation of Serum β-2 Microglobulin to PINK

Comparison of chemotherapy with or without asparaginase for extranodal nasal NK/T‐cell lymphoma in children and adolescents

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