Abstract
To identify simple non-invasive prognostic factors for extranodal natural killer/T cell lymphoma (ENKTL), we have investigated the prognostic value of pretreatment β2-microglobin to lymphocytes ratio index (βLRI) or lactate dehydrogenase to lymphocytes ratio index (LLRI), by analyzing the retrospective data from 211 ENKTL patients. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of pretreatment βLRI and LLRI. The univariate analysis indicated that Ann Arbor Stage (p = 0.008), Eastern Cooperative Oncology Group score (ECOG) (p = 0.009), International Prognostic Index (IPI) (p = 0.023), βLRI (p = 0.003), LLRI (p = 0.04), neutrophil-lymphocyte ratio index (p = 0.025) and monocyte/granulocyte to lymphocyte ratio (p = 0.030) were significantly associated with overall survival (OS) in ENKTL patients. However, multivariate analysis demonstrated that only Ann Arbor Stage (p = 0.028), βLRI (p < 0.001) and LLRI (p = 0.006) were only correlated independently with OS. Furthermore, βLRI and LLRI based new prognostic model showed improved discrimination for stage IE/IIE upper aerodigestive tract in ENKTL patients than IPI and Korean Prognostic Index. Overall, our study concluded that new βLRI-based prognosis model is useful to stratify ENKTL patients and higher βLRI and LLRI can act as independent prognostic predictor candidates in early stage ENKTL.
Highlights
Extranodal natural killer/T cell lymphoma (ENKTL) is a highly aggressive non-Hodgkin lymphoma, distinguished from other subtypes on the basis of its unique characteristics, such as predominant involvement of the nasal cavity and nasopharynx, high prevalence in East Asia and South America, and relationship to EpsteinBarr virus infection
To identify simple non-invasive prognostic factors for extranodal natural killer/T cell lymphoma (ENKTL), we have investigated the prognostic value of pretreatment β2-microglobin to lymphocytes ratio index or lactate dehydrogenase to lymphocytes ratio index (LLRI), by analyzing the retrospective data from 211 ENKTL patients
We have assessed the prognostic value of β2-microglobin to lymphocytes ratio index (βLRI) and LLRI with other clinical factors in early-stage ENKTL patients
Summary
Extranodal natural killer/T cell lymphoma (ENKTL) is a highly aggressive non-Hodgkin lymphoma, distinguished from other subtypes on the basis of its unique characteristics, such as predominant involvement of the nasal cavity and nasopharynx, high prevalence in East Asia and South America, and relationship to EpsteinBarr virus infection. The treatment outcomes of ENKTL are generally poor, and vary widely [1,2,3]. Two major prognostic models have been utilized for NK/T-cell lymphoma: The International Prognostic Index (IPI) and the Korean Prognostic Index (KPI). IPI has not gained widespread acceptance for ENKTL prognosis, as 60% of the ENKTL patients are grouped into low IPI risk categories (score, 0–1). The KPI model appears to be more useful for predicting ENKTL prognosis [4,5,6], as stage III or IV patients are included in the KPI model. Some patients in the low KPI risk group still have poor clinical outcomes [7], which indicate that the scoring systems based on both these models should be further modified
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