84例鼻型NK/T细胞淋巴瘤的治疗与预后分析

目的 分析鼻型NK/T细胞淋巴瘤的临床特征、不同治疗方法的疗效及影响预后的因素.方法 回顾性分析经病理证实的84例鼻型NK/T细胞NHL患者的临床资料,其中48例经免疫组化证实.根据Ann Arbor分期,Ⅰ期46例,Ⅱ期19例,Ⅲ期16例,Ⅳ期3例.单纯放疗29例,单纯化疗5例,放疗、化疗结合50例.预后判断采用Cox多因素回归模型分析.结果 全组5年总生存（OS）和无病生存（DFS）率分别为48.8%与35.7%.首程治疗后达CR的5年OS为59.4%,未达CR的5年OS为15.0%（P＜0.01）.单纯化疗中1例达CR（20.0%）,单纯放疗21例达CR（72.4%）,放疗、化疗结合42例达CR（84.0%）,放疗、化疗结合与单纯放疗后达CR明显高于单纯化疗（P＜0.01）.单纯放疗和放疗、化疗结合的5年OS率分别为44.8%和54.0%（P＞0.05）,均明显高于单纯化疗20.0%（P＜0.05）;单纯放疗和放疗、化疗结合的5年DFS分别为34.5%、40.0%,明显高于单纯化疗（P＜0.01）.多因素回归分析显示：IPI、首程CR、B症状、鼻中隔和（或）硬腭穿孔及治疗方法为影响生存的独立预后因素,其中以IPI评分最明显.结论 对鼻型NK/T淋巴瘤采用单纯化疗疗效差,而放疗、化疗结合疗效较好,但远期生存情况仍不满意.     

疗前血清Hb水平在早期结外鼻型NK/T细胞淋巴瘤中的预后价值

目的 探讨治疗前血清Hb水平对早期结外鼻型NK/T细胞淋巴瘤预后的影响。 方法 回顾分析2000—2015年间收治的 175例Ⅰ、Ⅱ期结外鼻型NK/T细胞淋巴瘤。纳入标准为原发病灶位于上消化呼吸道,不合并其他恶性疾病,治疗及随访记录完整病例纳入分析。接受单纯化疗 67例、单纯放疗 8例、放化疗 100例。Kaplan-Meier法计算生存率,Logrank法单因素分析,Cox模型多因素分析。 结果 175例患者的变量单因素分析显示疗前血清Hb水平(≥120 g/L)、LDH水平(正常)、ECOG评分(0~1)、Ann Arbor分期(Ⅰ_{E)、接受放疗显著提高PFS及OS (P=0.000~0.046)。多因素分析显示血清Hb水平、LDH水平、ECOG评分、Ann Arbor分期是患者PFS、OS影响因素(P=0.000~0.040)。 结论 疗前Hb≥120 g/L者预后好于<120 g/L者。}     

早期结外鼻型NK/T细胞淋巴瘤疗后远处淋巴结转移的临床特征

目的 分析 Ⅰ_E~Ⅱ_E期原发上呼吸消化道NK/T细胞淋巴瘤(UADT-NKTCL)经治疗后远处淋巴结转移率及危险因素。方法 1979—2012年共收治 468例Ⅰ_E~Ⅱ_E期UADT-NKTCL患者,其中 170例接受单纯放疗、19例单纯化疗、278例综合治疗、1例抗炎治疗。采用Kaplan-Meier法计算远处淋巴结转移率。结果 中位随访35个月,32例出现远处淋巴结转移,绝对转移率为6.8%(32/468),占总失败病例数的19.8%(32/162),2年远处淋巴结累积转移率为6.4%。71.9%(23/32)合并远处器官转移。最常见转移部位是腹腔淋巴结。单因素分析显示肿瘤原发于鼻腔外上呼吸消化道、Ⅱ_E期、首程治疗疗效未达CR者是远处淋巴结转移的高危因素。多因素分析显示 Ⅱ_E期和首程治疗疗效未达CR是远期复发的独立危险因素,危险度分别为2.82(1.37~5.82,P=0.005)和3.01(1.16~7.78,P=0.023)。Ⅱ_E期综合治疗组的远处淋巴结转移率显著低于单纯放疗组、单纯化疗组,2年远处淋巴结累积转移率分别为12.5%、35.1%、50.0%(P=0.011)。结论 早期UADT-NKTCL治疗后远处淋巴结转移率较低,但对于 Ⅱ_E期和首程疗效未达CR者转移率仍较高。Ⅱ_E期患者建议采用综合治疗以降低远处淋巴结转移率。     

早期结外鼻型NK/T细胞淋巴瘤疗后远期复发因素分析

目的 分析Ⅰ_E~Ⅱ_E期上呼吸消化道NK/T细胞淋巴瘤(UADT-NKTCL)经治疗后无瘤生存超过5年患者的远期复发率及危险因素。
方法 1983-2007年共114例Ⅰ_E~Ⅱ_E期UADT-NKTCL患者疗后5年内无瘤生存,其中32例单纯放疗、80例化放疗、2例单纯化疗。采用Kaplan-Meier方法计算复发率并Logrank检验及危险因素的单因素分析,Cox模型进行多因素分析。
结果随访率100%,随访时间满10年者79例。全组5年后复发12例(10.5%),复发中位时间8.2年(5.1~23.1年)。复发者中50%出现局部区域复发而无远处器官或淋巴结受累。全组10年肿瘤特异生存率和累积远期复发率分别为92.2%和8.4%。单因素分析显示初诊时有全身症状、ECOG评分≥2分、单纯化疗、初治时放疗剂量<50 Gy是远期复发因素(χ²=4.00~11.14,P=0.004~0.045),多因素分析显示初诊存在全身症状是远期复发危险因素[HR=4.74(95%CI=1.33~16.94),χ²=5.73,P=0.017]。
结论 早期UADT-NKTCL疗后5年内无瘤生存者仍有部分会出现复发。初诊时全身症状是UADT-NKTCL远期复发的独立危险因素。     

原发肿瘤负荷对结外鼻型NK/T细胞淋巴瘤预后影响

目的 结外鼻型NK/T细胞淋巴瘤尚缺乏有效临床预后和治疗决策因子。本研究旨在定义原发肿瘤负荷(PTB)的临床特征和预后作用。方法 共回顾性收录10家医院1383例病例,其中Ⅰ期947例(68.5%),Ⅱ期326例(23.6%),Ⅲ—Ⅳ期110例(8.0%)。751例患者(54.3%)具有高PTB (H-PTB)特征。Kaplan-Meier法计算生存率Logrank检验,Cox模型多因素分析。结果 H-PTB与疾病侵袭性高、B症状、进展期、区域淋巴结受累、乳酸脱氢酶升高及一般状况差相关。H-PTB组5年OS、PFS更差,分别为50.2%、41.8%,对比低P3TB (L-PTB)分别为72.1%、62.5%(P=0.000、0.000)。多因素分析PTB是OS (HR=1.851)和PFS (HR=1.755)的独立预后因素。H-PTB在局限期患者中,与局部区域控制降低有关,5年局部区域控制率为71.6%,对比L-PTB组为84.3%(P=0.000)。结论 NKTCL中,H-PTB与多个不良临床特征相关,是生存和LC的不良预后因素。H-PTB可作为疾病风险分层和治疗调整的可靠指标。     

Allelotyping of gastrointestinal nasal-type NK/T-cell lymphoma

Nasal-type natural killer/T-cell lymphoma (NKL) is a rare but distinct malignancy that often involves the mid-facial region and the gastrointestinal tract. This study is the first genome-wide allelotyping analysis on this rare lymphoma. We applied 382 microsatellite markers covering loci which spanned 22 autosomes to screen for allelic imbalances (AI) in six intestinal NKL. The most common chromosomal regions of allelic imbalances were found in 11p, 9q and 13q. Novel spots of allelic losses spots found at 2p21, 2q37.22, 18p11.21 and 18q12.1. In spite of presence of a few recurrent loci of imbalances, the allelotyping results show that NKL is heterogeneous.     

早期结外鼻型NK／T细胞淋巴瘤治疗后淋巴结失败患者的预后分析

目的分析Ⅰ-Ⅱ期原发上呼吸消化道NK／T细胞淋巴瘤（UADT—NKTCL）治疗后淋巴结失败患者的生存和预后因素。方法1988年4月至2012年12月40例Ⅰ-Ⅱ期UADT—NKTCL患者在接受治疗后的随访中出现了淋巴结失败,对失败后的生存和预后进行分析。采用Kaplan—Meier法计算生存率。结果40例患者中,8例单纯区域淋巴结失败,26例单纯远处淋巴结失败,6例同时合并区域和远处淋巴结失败。57．1％（8／14）的患者区域淋巴结失败合并局部复发,71．9％（23／32）的患者远处淋巴结失败合并远处器官失败。全组患者淋巴结失败后中位生存时间为8．7个月,2年总生存率29．8％。预后分析显示,淋巴结失败时患者B症状和美国东部肿瘤协作组（ECOG）评分是预后因素。有B症状的患者中位生存时间为6．6个月,而无B症状的患者为16．3个月,两者差异有统计学意义（P=0．034）。ECOG评分0～1分的患者中位生存时间显著长于ECOG评分1〉2分的患者,分别为31．6个月和4．1个月（P〈0．001）。综合治疗的预后显著优于单纯化疗,2年生存率分别为68．6％和15．0％（P〈0．001）。结论早期UADT-NKTCL治疗后出现淋巴结失败的患者总体预后差,挽救性综合治疗可取得较好效果。     

结外NK/T细胞淋巴瘤患者鼻腔菌群失调与预后的关系

目的 探讨鼻腔菌群失调与结外NK/T细胞淋巴瘤（extranodal NK/T-cell lymphoma,ENKTCL）预后的相关性。方法 回顾性分析244例初治ENKTCL患者的临床资料及鼻拭子培养结果,根据是否存在鼻腔菌群失调将患者分为菌群正常组（n=114）和菌群失调组（n=130）,并分析菌群失调与患者临床病理特征、治疗效果及预后的关系。结果  菌群失调组患者共培养出409株优势菌株,以金黄色葡萄球菌、草绿色链球菌、表皮葡萄球菌及铜绿假单胞菌为主。菌群失调组患者的乳酸脱氢酶升高比例高于菌群正常组（P=0.044）,预后评分PINK≥1的中危或高危患者比例亦高于菌群正常组（P=0.003）。治疗结束时,菌群失调组患者的完全缓解率显著低于菌群正常组（45.5% vs 61.4%,P<0.05）,5年无疾病进展生存率亦低于菌群正常组（48.4% vs 63.9%,P=0.048）。亚组分析显示,早期及PINK低危患者中,菌群失调与否与患者的无疾病进展生存期有关（P=0.022, 0.011）。结论 鼻腔菌群失调与ENKTCL患者预后密切相关,针对鼻腔菌群失调的措施可能进一步改善ENKTCL的治疗效果及预后。     

皮下脂膜炎样T细胞淋巴瘤与皮肤的结外鼻型NK/T细胞淋巴瘤的对比研究

目的:通过对20例皮下脂膜炎样T细胞淋巴瘤(subcutaneous panniculitis-like T-cell lymphoma,SPTL)和19例皮肤的结外鼻型NK/T细胞淋巴瘤的对比研究,加深对2者的认识.方法:从临床病理、免疫标记、EB病毒(Epstein-Barr virus,EBV)感染和T细胞受体(T-cell receptor, TCR)基因重排等多个方面对2者进行比较.结果: 临床表现上2者不易鉴别,但皮肤NK/T细胞淋巴瘤常伴皮肤外播散、预后差;组织学上,SPTL常严格局限于皮下脂肪组织,而皮肤NK/T细胞淋巴瘤以真皮为中心形成弥漫性浸润,常累及皮下脂肪层,更易于见到大片凝固性坏死、血管中心性浸润和亲表皮现象;免疫表型上,SPTL常表达βF1、膜型CD3、CD8,不表达CD4、CD56,而大部分皮肤NK/T细胞淋巴瘤则表达CD56和细胞质CD3ε,仅少数表达膜型CD3、CD8.CD56、CD3、CD8和βF1的表达差异有统计学意义(P<0.05).SPTL患者中检出 EBER1/2原位杂交阳性,而皮肤NK/T细胞淋巴瘤100%病例为阳性,2者比较差异有统计学意义(P<0.05).SPTL患者中检出TCR-γ基因克隆性重排,而皮肤NK/T细胞淋巴瘤患者仅有4/18例(22.2%)检出重排,2者之间差异有统计学意义(P<0.05).结论:有无皮肤外播散,组织学上有无大片凝固性坏死、血管中心性浸润和亲表皮现象,是否表达免疫组织化学标记CD56、CD3、CD3ε、CD8和βF1,EB病毒原位杂交阳性与否,以及TCR-γ克隆性重排检出与否,均可作为SPTL和皮肤NK/T细胞淋巴瘤的鉴别要点.准确鉴别2者需综合临床、组织病理学、免疫表型、EB病毒感染和基因重排等结果进行全面分析.     

结外NK/T细胞淋巴瘤鼻型25例预后因素探讨

结外NK／T细胞淋巴瘤鼻型近年来发病率有上升趋势,我们以1999年到2003年于我院住院的25例结外NK／T细胞淋巴瘤鼻型患者为研究对象,就其预后因素进行探讨。     

Therapeutic outcome of extranodal NK/T-cell lymphoma initially treated with chemotherapy--result of chemotherapy in NK/T-cell lymphoma

The therapeutic outcome of chemotherapy in NK/T cell lymphoma (NTCL) has not been well documented until now. The aims of this study were to investigate the outcome of chemotherapy and to evaluate the clinical factors influencing the responsiveness to chemotherapy. Between 1995 and 2000, 59 patients received anthracycline-based chemotherapy as an initial treatment. Forty-five patients had nasal NTCL, whereas 14 had extranasal NTCL. Forty-one patients had stage I/II and 18 had stage III/IV disease. Epstein-Barr virus status was positive in 67.6% of cases. The results of initial chemotherapy were complete remission in 35.6% of the patients, 2-year disease-free survival in 22.9% and 2-year overall survival in 44.2%. Adjuvant radiotherapy after chemotherapy did not improve outcome in stage I/II nasal NTCL. The International Prognostic Index was a significant prognostic factor of complete remission rate, and stage was also significant for disease-free survival.     

局部区域复发早期结外鼻型NK/T细胞淋巴瘤挽救治疗初步预后分析

目的 回顾分析局部区域复发的早期结外鼻型NK/T细胞淋巴瘤挽救治疗预后因素。方法 按入组标准纳入1995-2014年间首次治疗后出现局部区域复发且接受了挽救治疗的早期结外鼻型NK/T细胞淋巴瘤56例,分析挽救治疗对OS、复发后OS的影响,并对复发后OS进行单因素及多因素预后分析。结果 总中位随访时间 35.9个月,3年OS率为73%。复发后中位随访时间14.8个月,3年复发后OS率为58%。挽救治疗方式中加入放疗较单纯化疗提高了OS (P=0.040)和复发后OS (P=0.009),二程放疗较单纯化疗提高了OS (P=0.018)和复发后OS (P=0.019),二程放疗的急性及晚期不良反应多为1-2级(84%)。在单因素和多因素分析中KPS评分、首治有无放疗、挽救有无放疗均对复发后OS有影响。结论 放疗是局部区域复发的结外鼻型NK/T细胞淋巴瘤挽救治疗中不可或缺手段,能改善生存且不良反应可接受。     

Clinical significance of circulating exosomal PD-L1 and soluble PD-L1 in extranodal NK/T-cell lymphoma,nasal-type

Exosomal PD-L1 (exoPD-L1) is reported to be associated with immunosuppression in various cancers. However, its clinical value in extranodal NK/T cell lymphoma (ENKTL) has not been defined yet. We retrospectively evaluated the prognostic value of pretreatment circulating soluble PD-L1 (sPD-L1) and exosomal PD-L1 (exoPD-L1) in ENKTL patients treated with VIPD-containing chemotherapy. A total of 107 ENKTL patients, including 101 early stage and 6 advanced stage patients were enrolled in our study. ExoPD-L1 and sPD-L1 in the blood were measured by single molecule array (Simoa) and enzyme-linked immunosorbent assay (ELISA), respectively. Compared with the healthy individuals (n=16), the patients with ENKTL (n=107) exhibited significantly elevated exoPD-L1 and sPD-L1 levels in the blood. High pretreatment plasma exoPD-L1 concentration was associated with higher SUVmax level and recurrence rate. Similarly, high sPD-L1 group was also associated with some adverse clinical parameters, including advanced stage, elevated LDH levels, B symptoms, high IPI score and PINK score. The 5-year progression-free survival (PFS) rate and overall survival (OS) rates were 65.2% and 85.7% for the whole cohort, respectively. Patients with a low pretreatment exoPD-L1 level (simoa signal < 1.2) had 5-year OS and PFS rates of 88.1% and 86.1%, respectively, compared with 56.0%. (P=0.012) and 35.7% (P=0.007) in patients with high exoPD-L1 level (simoa signal > 1.2). The 5-year OS and PFS rates for patients with low sPD-L1 group (< 219 pg/mL) was significantly higher than high sPD-L1 group (≥ 219 pg/mL) (OS, 91.3% vs. 55.5%, P < 0.001; PFS, 68.9% vs. 34.6%, P=0.003). However, no correlation was found between circulating exoPD-L1 and sPD-L1 levels. This is the first study to measure plasma exoPD-L1 level on the Quanterix Simoa platform. Our results proved that circulating exoPD-L1 and sPD-L1 levels were significantly elevated in ENKTL and might be potential biomarkers for predicting the survival outcomes of ENKTL patients.     

结外NK/T细胞淋巴瘤L-GEMOX方案治疗的临床观察

目的：观察L-GEMOX方案对结外NK/T细胞淋巴瘤的近期疗效和安全性。方法：回顾性分析32例经病理形态学及免疫组化证实为结外NK/T细胞淋巴瘤患者,均接受L-GEMOX方案治疗,至少接受2个周期。32例患者接受4个周期化疗后行疗效评价,诱导化疗后行序贯累计野放疗。结果：32例结外NK/T细胞淋巴瘤患者中,诱导化疗后完全缓解（CR）率为53.1％（17/32）,部分缓解（PR）率为31.3％（10/32）,疾病稳定（SD）率为9.4％（3/32）,疾病进展（PD）率为6.3％（2/32）。完成放射治疗后,CR率为62.5％（20/32）, PR率37.5％（12/32）,有效率为100％。临床特征分析显示原发部位、临床分期与患者近期疗效相关（P＜0.05）。主要不良反应为骨髓抑制、黏膜炎、转氨酶升高及血糖波动等,多为轻中度,予对症处理或化疗停止后很快缓解。无治疗相关死亡。结论：培门冬酶及吉西他滨联合奥沙利铂（ L-GEMOX）作为一线诱导化疗方案,对结外NK/T细胞淋巴瘤的近期疗效佳,不良反应轻,安全性好,是Ⅰ期、Ⅱ期鼻NK/T细胞淋巴瘤新的治疗选择。将来需进一步开展大样本的前瞻性研究,评估L-GEMOX方案能否改善结外NK/T 细胞淋巴瘤的总生存期和无病生存期。     

结外NK/T细胞淋巴瘤的免疫靶向治疗进展

结外NK/T细胞淋巴瘤（extranodal NK/T-cell lymphoma,ENKTCL）是一种高度侵袭性的非霍奇金淋巴瘤,对以门冬酰胺酶为基础的化疗方案较敏感,但仍有部分患者预后不佳。近年来,随着对ENKTCL发病机制的进一步了解,认为免疫靶向治疗在初治或复发难治ENKTCL患者治疗中具有重要的临床价值。本文就单克隆抗体类药物、靶向细胞信号传导通路的小分子抑制剂、表观遗传学药物、免疫调节剂、EBV特异性细胞毒性T细胞及嵌合抗原受体修饰的T细胞治疗在ENKTCL中的临床前研究及临床试验等研究进展进行综述。     

Early or up-front radiotherapy improved survival of localized extranodal NK/T-cell lymphoma, nasal-type in the upper aerodigestive tract

PURPOSE: To investigate the role of early or up-front radiotherapy (RT), the optimal RT dose required to achieve appropriate treatment outcome and prognostic factors for patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. METHODS AND MATERIALS: Eighty-two patients were reviewed. Eight patients were treated with chemotherapy (CT) alone, 9 patients received RT alone, and 65 patients were given combined modality treatment of CT and RT (CMT). Of those 74 patients receiving RT, 31 patients were given up-front RT, whereas CT was the initial therapy for 43 patients and 41 of those 43 patients received early RT. RESULTS: Five-year overall survival (OS) and disease-free survival (DFS) were 52.3% and 39.2%, respectively. RT was the only independent prognostic factor for both OS and DFS at both the univariate and multivariate level. The 5-year OS and DFS were better in patients receiving >or=54 Gy of RT as compared with that of <54 Gy (5-year OS 75.5% vs. 46.1%, p = 0.019; 5-year DFS 60.3% vs. 33.4%, p = 0.004). Up-front RT presented better survival in Stage I patients when compared with that of initial CT followed by early RT (5-year OS 90.0% vs. 48.9%, p = 0.012; 5-year DFS 78.7% vs. 39.9%, p = 0.021). CONCLUSION: Early or up-front RT had an essential role in improved OS and DFS in patients with localized extranodal NK/T-cell lymphoma, nasal-type, in the upper aerodigestive tract. The recommended tumor dose was at least 54 Gy. Up-front RT may yield more benefits on survival in patients with Stage I disease.     

Icaritin induces lytic cytotoxicity in extranodal NK/T-cell lymphoma

Background

Extranodal NK/T-cell lymphoma (ENKL) is an aggressive hematological malignancy associated with Epstein–Barr virus (EBV) infection. It is often resistant to conventional chemotherapy and has a poor prognosis. Icaritin, a compound derived from Chinese herbal medicine, Herba Epimedii, has been reported to exert antitumor effects on a variety of cancer cell lines. In the present study, we investigated the cytotoxic effects of Icaritin on the two EBV-positive ENKL cell lines SNK-10 and SNT-8, along with the underlying molecular mechanisms.

Methods

ENKL cell lines SNK-10 and SNT-8 were exposed to different concentrations of Icaritin for the indicated time. Treated cells were analyzed for cell proliferation, cell cycle, and cell apoptosis. Phosphorylation of Stat3 and Akt proteins in signaling pathways and the EBV-encoded LMP1 proteins were measured by Western blot. Expression of EBV genes was assessed by Real-Time PCR.

Results

Our results showed that Icaritin dose-dependently inhibits ENKL cell proliferation and induces apoptosis and cell cycle arrest at G₂/M phase. Additionally, Icaritin upregulates Bax, downregulates Bcl-2 and pBad, and activates caspase-3 and caspase-9. The anti-proliferative and pro-apoptotic effects of Icaritin are likely mediated by inhibition of Stat3 and Akt pathways through LMP1 downregulation. Importantly, Icaritin induces EBV lytic gene expression in ENKL cells, and the combination of Icaritin and the antiviral drug ganciclovir (GCV) is more effective in inducing ENKL cells apoptosis than Icaritin or GCV alone.

Conclusions

These findings indicate that EBV-targeted approaches may have significant therapeutic potential for ENKL treatment.     

Skp2表达在结外NK/T细胞性淋巴瘤中的意义

Background and Objective:Expression of Skp2 was related with the prognosis of several tumors.However,there was no intensive study on the relationship between Skp2 and extranodal NK/T-cell lymphoma.This study was to explore the role of Skp2 in extranodal NK/T-cell lymphoma.Methods:The clinicopathological data of 39 patients with extranodal NK/T-cell lymphoma were analyzed.The expression of Skp2 was examined by immunohistochemistry on formalin-fixed,paraffin-embedded tissue sections.Results:Among the patients...     

贫血在结外鼻型NK/T细胞淋巴瘤预后价值——中国淋巴瘤放疗协作组多中心研究

目的 分析贫血在结外鼻型NK/T细胞淋巴瘤中的预后价值。方法 回顾分析 1225例在中国10个医疗中心确诊并且接受首程治疗的结外鼻型NK/T细胞淋巴瘤。中国贫血标准:海平面地区成年男性Hb<120 g/L,成年女性<110 g/L。贫血程度分级:极重度Hb≤30 g/L,重度 31~60 g/L,中度 61~90 g/L,轻度>90 g/L。结果 全组患者就诊时有 199例伴有贫血,占16.2%。贫血患者具有更多预后不良因素,贫血患者中分期为Ⅱ—Ⅳ期、中位年龄>60岁、ECOG评分2—4分、NK/T细胞淋巴瘤预后指数≥2分的比例较高。贫血、非贫血患者 5年OS分别为49.4%、63.3%(P<0.01),5年PFS分别为35.4%、56.0%(P<0.01)。单因素分析显示贫血、年龄、ECOG评分、B组症状、乳酸脱氢酶、原发部位、原发肿瘤侵犯以及分期是OS和PFS影响因素,多因素分析显示贫血仍然是预后影响因素。结论 贫血在结外鼻型NK/T细胞淋巴瘤中少见,这部分患者预后较差,贫血是预后影响因素。