Originally published as JCO Early Release 10.1200/JCO.2005.04.1384 on December 27 2005

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Extranodal Natural Killer T-Cell Lymphoma, Nasal-Type: A Prognostic Model From a Retrospective Multicenter Study

From the Division of Hematology-Oncology, Department of Medicine, Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine; Division of Hematology-Oncology, Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine; Department of Hematology-Oncology, Korea Cancer Center Hospital; Department of Hematology-Oncology, Dankook University School of Medicine; Department of Internal Medicine, College of Medicine, Hallym University, Seoul, Korea; Department of Hematology-Oncology, Gachun Medical School Gil Medical Center, Incheon; Research Institute & Hospital, National Cancer Center, Goyang, Gyeonggi; Dong-A Cancer Center, Dong-A University College of Medicine, Busan; Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul Department of Medicine, Cheju National University College of Medicine, Jeju, Korea

Address reprint requests to Won Seog Kim, MD, PhD, Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong Kangnam-ku, Seoul 135-710 Korea; e-mail: wskimsmc{at}smc.samsung.co.kr OR wskimsmc{at}hanmail.net

PURPOSE: Patients with natural killer T (NK/T) -cell lymphomas have poor survival outcome, and for this condition there is no optimal therapy. The purpose of this study was to design a prognostic model specifically for extranodal NK/T-cell lymphoma, which can identify high-risk patients who need more aggressive therapy.

PATIENTS AND METHODS: This multicenter retrospective study was comprised of 262 patients who were diagnosed with NK/T-cell lymphoma.

RESULTS: After a median follow-up duration of 51.2 months, 5-year overall survival rate in 262 patients was 49.5%. Prognostic factors for survival were "B" symptoms (P = .0003; relative risk, 2.202; 95% CI, 1.446 to 3.353), stage (P = .0006; relative risk, 2.366; 95% CI, 1.462 to 3.828), lactate dehydrogenase (LDH) level (P = .0005; relative risk, 2.278; 95% CI, 1.442 to 3.598), and regional lymph nodes (P = .0044; relative risk, 1.546; 95% CI, 1.009 to 2.367). Of 262 patients, 219 had complete information on four parameters. We identified four different risk groups: group 1, no adverse factor; group 2, one factor; group 3, two factors; and group 4, three or four factors. The new model showed a superior prognostic discrimination as compared with the International Prognostic Index (IPI). Notably, the distribution of patients was balanced when a new model was adopted (group 1, 27%; group 2, 31%; group 3, 20%; group 4, 22%), whereas 81% of patients were categorized as low or low-intermediate risks using IPI.

CONCLUSION: The newly proposed model for extranodal NK/T-cell lymphoma demonstrated a more balanced distribution of patients into four groups with better prognostic discrimination as compared with the IPI.

J.L., C.S., and Y.H.P. contributed equally to the work presented here.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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