Abstract
BackgroundExtranodal natural killer/T-cell lymphoma, nasal type (ENKTL), is an aggressive type of lymphoma whose standard treatment and validated prognostic model have not yet been defined.MethodsCD30 expression was detected using immunohistochemistry in 96 ENKTL patients, and the data were used to evaluate its relationship with clinical features, treatment response and prognosis.ResultsExpression of CD30 was detected in 31.2% of ENKTL patients, which was significantly correlated with B symptoms and elevated serum lactate dehydrogenase. The complete remission rate was not significantly different between CD30-positive and negative groups. After a median follow-up time of 31 months, 5-year overall survival (OS) and 5-year progression-free survival (PFS) rates in the CD30-positive group were both significantly lower than those in the CD30-negative group (34.1% vs. 64.4%, P = 0.002, for 5 year-OS; 26.0% vs. 66.7%, P < 0.001, for 5 year-PFS). In patients with an International Prognostic Index (IPI) or Korean Prognostic Index (KPI) score of 0–1, CD30 positivity was associated with shorter 5-year OS and PFS (IPI: P = 0.001 and 0.002, respectively; KPI: P = 0.018 and 0.023, respectively). In a multivariate Cox regression model, CD30 expression and stage were independent prognostic factors for OS (p = 0.004 and p = 0.012, respectively) and PFS (p = 0.001 and p = 0.022, respectively).ConclusionsOur results showed that expression of CD30 was not related to response to treatment but was an independent prognostic factor for both OS and PFS in ENKTL, nasal type, which suggests a role for CD30 in the pathogenesis of this disease and may support the incorporation of anti-CD30-targeted therapy into the treatment paradigm for ENKTL.
Highlights
Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), is an aggressive type of lymphoma whose standard treatment and validated prognostic model have not yet been defined
The majority of patients initially presented with upper aerodigestive tract NK/T-cell lymphoma (UNKTL) tumors (n = 63, 65.6%) or localized disease
CD30 expression did not appear to affect the response to GELOX or EPOCH chemotherapy, survival analysis indicated that CD30positive patients had a significantly inferior overall survival (OS) and progression-free survival (PFS)
Summary
Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), is an aggressive type of lymphoma whose standard treatment and validated prognostic model have not yet been defined. Extranodal natural killer (NK)/T-cell lymphoma (ENKTL), nasal type, is a distinct and heterogeneous histopathologic subtype of non-Hodgkin lymphoma (NHL) characterized by vascular damage and destruction, prominent necrosis and association with the Epstein-Barr virus (EBV) [1,2]. Owing to its poor prognosis, a great deal of clinical and pathological work has been undertaken to study prognostic markers in ENKTL. The prognostic value of KPI could not be repeated in some studies, especially in the era of asparaginase-based chemotherapy [7], suggesting that both IPI and KPI scoring systems could be further improved. The two prognostic models are based on clinical features before treatment; the pathological or molecular markers for predicting the outcome of ENKTL have not yet been well defined. Some useful biomarkers have been found to be independent prognostic factors in ENKTL [8], such as serum levels of interleukin-9 [9] and serum C-reactive protein [10]
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