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。

Prognostic value of anemia in patients with extranodal nasal-type NK/T cell lymphoma:A multi-center study from CLROG

Objective To evaluate the prognostic value of anemia in patients diagnosed with extranodal nasal-type natural killer (NK)/T cell lymphoma (NKTCL). Methods Clinical data of 1225 NKTCL patients receiving the first course of treatment from 10 medical institutions in China were retrospectively analyzed. According to the diagnostic criteria in China, anemia was defined as the hemoglobin (Hb) level< 120 g/L for the male and< 110 g/L for the female from the sea-level area. The severity of anemia was classified into the extremely severe anemia (Hb ≤ 30 g/L), severe anemia (31-60 g/L), moderate anemia (61-90 g/L) and mild anemia (>90 g/L). Results Among 1225 patients, 199(16.2%) were complicated with anemia, who had more adverse prognostic factors compared with their counterparts without anemia. Among NKTCL patients with anemia, the proportion of patients with stage Ⅱ-IV, a median age> anemia, Eastern Cooperative Oncology Group (ECOG) score of 2-4 and NK/T-cell lymphoma prognostic index (NKTCLPI) ≥ 2 was relatively high. Patients with anemia obtained worse clinical prognosis than those without anemia. The 5-year overall survival (OS) and progression-free survival (PFS) in NKTCL patients with anemia were calculated as 49.4% and 35.4%, significantly lower compared with 63.3% and 56.0% in their counterparts without anemia (both P<0.01). Single factor analysis demonstrated that anemia, age, ECOG score, group B symptom, lactate dehydrogenase, primary tumor site, primary tumor invasion and staging were the prognostic factors of OS and PFS. Multivariate analysis revealed that anemia was still the independent prognostic factor. Conclusions Anemia is not common in patients with NKTCL and these patients obtain poor clinical prognosis. Anemia is an independent prognostic factor for patients with NKTCL.