Characteristics and Outcome of Extranodal NK/T-cell Lymphoma in North America: A Retrospective Multi-Institutional Experience |
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| Institution: | 1. Research Service, St Louis Veterans Affairs Medical Center, St. Louis, MO;2. Division of Oncology, Washington University School of Medicine, St. Louis, MO;3. Division of Hematology, Mayo Clinic, Rochester, MN;4. Division of Oncology, Stanford Cancer Institute, CA;5. Centre for Lymphoid Cancer and Department of Medical Oncology, BC Cancer, Vancouver, BC;6. Divisions of Hematology/Oncology, UCLA, Los Angeles, CA;7. Divisions of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE;8. Divisions of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Boston, MA;9. U Mass Memorial Cancer Center, Worcester, MA;10. Divisions of Hematology/Oncology, University of Chicago, Chicago, IL;11. Division of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY;12. Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Cancer Center, Kansas City, KS;1. Hematology department, Anticancer Centre Léon Bérard, Lyon, France;2. Hematology Department, Saint Louis Hospital, Paris, France;3. Institut Gustave Roussy, Villejuif, France;4. Hématologie Clinique, Dijon University Hospital, Dijon, France;5. Hematology, CHU Caen, Caen, France;6. Hematology, Limoges university hospital, Limoges, France;7. Hematology, CHRU de Lille, Lille, France;8. Service d''hématologie, Institut Universitaire du Cancer de Toulouse - Oncopole, CHU de Toulouse, Toulouse, France;9. Inserm U1245 and Department of Hematology, Centre Henri Becquerel and Normandie Univ UNIROUEN, Rouen, France;10. Hematology, CHU Bordeaux, Pessac, France;11. Hematology, Hopital Mignot, Le Chesnay, France;12. Department of Hematology, University Hospital, Amiens, France;13. Hematology, Henri Mondor Hospital, Creteil, France;14. Hematology, Military Hospital, Clamart, France;15. Hematology, Institut Paoli-Calmettes, Marseille, France;16. Hematology, Avicenne Hospital, APHP, Bobigny, France;17. Hematology, Centre Antoine Lacassagne, Nice, France;18. Hôpital Universitaire Necker-Enfants Malades, Paris, France;19. Hematology, CHU Angers, Angers, France;20. Hematology, CHU Grenoble, Grenoble, France;21. Hematology, CHU Nancy, Nancy, France;22. ALFA Group, Paris, France;23. Haematology Department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite, France;24. Paris-Diderot University, Paris, France;25. Pneumology department, Saint Louis Hospital, AP-HP, Paris, France;1. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX;2. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, University of Iowa, Iowa City, IA;2. Department of Biostatics, University of Nebraska Medical Center, Omaha, NE;3. Department of Internal Medicine, Rochester General Hospital, Rochester, NY;4. Nobel College, Pokhara University, Kathmandu, Nepal;5. Department of Internal Medicine, Division of Oncology and Hematology, University of Nebraska Medical Center, Omaha, NE;6. Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE;7. Department of Internal Medicine, Section of Hematology, Yale University School of Medicine and Yale Cancer Center, New Haven, CT;8. Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY;9. Division of Geriatrics, Gerontology and Palliative Medicine, University of Nebraska Medical Center, Omaha, NE |
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| Abstract: | BackgroundExtranodal natural killer/T-cell lymphoma (ENKTL) is rare and clinical data from non-Asian countries are lacking. It is unclear whether outcomes and disease natural history is similar to reported Asian series. We assessed characteristics and outcomes of patients with ENKTL from major North American centers.Patients and MethodsWe retrospectively identified patients with newly-diagnosed CD56 + ENKTL and studied disease characteristics and clinical outcomes.ResultsOne hundred and twenty-one patients with ENKTL diagnosed between June 1990 and November 2012 were identified. Eighty-three patients (69%) had stage I/II disease and were treated with combined modality therapy (CMT) (n = 53), chemotherapy alone (CT) (n = 14) or radiotherapy alone (RT) (n = 16). Thirty-eight patients (31%) had stage III/IV disease and were treated with CMT (n = 12), CT (n = 23), or RT (n = 3). The median follow-up for the entire cohort was 51 months. Patients with stage I/II disease, compared to those with stage III/IV disease, had superior 2-year progression free survival (PFS) 43% vs 19% (P = .03) and overall survival (OS) 59% vs. 29% (P= .004). Outcomes were similar for stage I/II patients who received CMT vs. RT alone with 2-year PFS (53% vs. 47%; P= .91) and OS (67% vs. 67%; P= .58). No significant differences in outcomes were noted based on race/ethnicity.ConclusionsThis series represents a large experience of ENKTL treated at several major North American academic centers. Our data are consistent with Asian studies: (1) majority of patients present with early-stage disease; (2) overall poor outcome regardless of race/ethnicity; (3) CMT likely yields favorable outcomes for suitable candidates with early-stage disease. |
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