A clinicohaematological prognostic model for nasal-type natural killer/T-cell lymphoma : a multicenter study

• Main Authors: Tan, Khee Ming, Chia, Burton, Lim, Jing Quan, Khoo, Lay Poh, Cheng, Chee Leong, Tan, Leonard, Poon, Eileen, Somasundaram, Nagavalli, Mohamad Farid, Tang, Tiffany Pooi Ling, Tao, Miriam, Cheah, Daryl Ming Zhe, Laurensia, Yurike, Pang, Jane Wan Lu, Song, Tammy, Tan, Jing, Huang, Dachuan, Kim, Seok Jin, Kim, Won Seog, Ong, Choon Kiat, Lim, Soon Thye, Chan, Jason Yongsheng
• Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
• Format: Article
• Language: English
• Published: 2020
• Subjects: Science::Medicine; Extranodal Natural Killer/T-cell Lymphoma (NKTL); Peripheral T-cell Lymphoma (PTCL)
• Online Access: https://hdl.handle.net/10356/142350
• Institution: Nanyang Technological University

Extranodal NK/T-cell lymphoma, nasal type (NKTL) is an aggressive type of non-Hodgkin lymphoma closely associated with Epstein-Barr virus and characterized by varying degrees of systemic inflammation. We aim to examine the prognostic significance of peripheral blood neutrophil-lymphocyte ratio (NLR) in patients with NKTL. Therefore, we conducted a retrospective review of 178 patients with biopsy-proven NKTL from the National Cancer Centre Singapore and Samsung Medical Center, South Korea. Using receiver operating curve analysis, an optimal cut-off for high NLR (>3.5) in predicting overall survival (OS) was derived. Survival analysis was performed using the Kaplan-Meier method and multivariable Cox proportional regression. In patients with high NLR, estimated 5-year OS was 25% compared to 53% in those with low NLR. In multivariable analysis, high NLR, in addition to age ≥60 years, presence of B-symptoms and stage III/IV at diagnosis, was independently correlated with worse OS (HR 2.08; 95% CI 1.36 to 3.18; p = 0.0008) and progression-free survival (HR 1.66; 95% CI 1.11 to 2.46; p = 0.0128). A new prognostic index (NABS score) derived from these factors stratified patients into low (0), low-intermediate (1), high-intermediate (2) and high (3-4) risk subgroups, which were associated with 5-year OS of 76.5%, 55.7%, 29.2% and 0% respectively. In conclusion, high NLR is an independent prognostic marker and the NABS model can be used to risk-stratify NKTL patients.