Clinical Outcomes and Prognostic Factors of Up-Front Autologous Stem Cell Transplantation in Patients with Extranodal Natural Killer/T Cell Lymphoma

Yhim, Ho Young; Kim, Jin Seok; Mun, Yeung Chul; Moon, Joon Ho; Chae, Yee Soo; Park, Yong; Jo, Jae Cheol; Kim, Seok Jin; Yoon, Dok Hyun; Cheong, June Won; Kwak, Jae Yong; Lee, Je Jung; Kim, Won Seog; Suh, Cheolwon; Yang, Deok Hwan

doi:10.1016/j.bbmt.2015.05.003

Cited by 82 publications

(85 citation statements)

References 36 publications

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“…In retrospective analyses, disease status at the time of transplant was the most important prognostic factor for OS and relapsefree survival. [41][42][43][44] In a retrospective analysis of 62 patients with newly diagnosed ENKL who underwent autologous HCT after primary therapy, those with early-stage disease had significantly better 3-year PFS (64% vs 40%; P=.017) and OS (68% vs 52%; P=.048) than those with advanced disease. 44 In the multivariate analysis, NK/T-cell prognostic index (for limited disease) and pretransplant response (for advanced-stage disease) were independent prognostic factors for survival.…”

Section: Hematopoietic Cell Transplantmentioning

confidence: 99%

“…[41][42][43][44] In a retrospective analysis of 62 patients with newly diagnosed ENKL who underwent autologous HCT after primary therapy, those with early-stage disease had significantly better 3-year PFS (64% vs 40%; P=.017) and OS (68% vs 52%; P=.048) than those with advanced disease. 44 In the multivariate analysis, NK/T-cell prognostic index (for limited disease) and pretransplant response (for advanced-stage disease) were independent prognostic factors for survival. In addition, RT was an independent prognostic factor for reduced progression and survival in patients with limited disease, and anthracycline-based chemotherapy was a poor prognostic factor for progression in patients with advanced disease.…”

Section: Hematopoietic Cell Transplantmentioning

confidence: 99%

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NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

Horwitz

Ansell

et al. 2018

J Natl Compr Canc Netw

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Natural killer (NK)/T-cell lymphomas are a rare and distinct subtype of non-Hodgkin's lymphomas. NK/T-cell lymphomas are predominantly extranodal and most of these are nasal type, often localized to the upper aerodigestive tract. Because extranodal NK/T-cell lymphomas (ENKL) are rare malignancies, randomized trials comparing different regimens have not been conducted to date and standard therapy has not yet been established for these patients. These NCCN Guidelines Insights discuss the recommendations for the diagnosis and management of patients with ENKL as outlined in the NCCN Guidelines for T-Cell Lymphomas.

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Section: Hematopoietic Cell Transplantmentioning

confidence: 99%

Section: Hematopoietic Cell Transplantmentioning

confidence: 99%

NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

Horwitz

Ansell

et al. 2018

J Natl Compr Canc Netw

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“…Although, several studies have investigated the clinical efficacy of ASCT relative to historical controls in the settings of upfront or salvage therapy, the results have been inconclusive. 7,8,10,11,[18][19][20] Overall survival gain has been demonstrated for patients who were treated with ASCT compared to those who were treated with chemotherapy. 7,8 In particular, patients with high-risk NKPI and who attained CR demonstrated significantly improved survival after undergoing ASCT.…”

Section: Discussionmentioning

confidence: 99%

“…7,20 Published data using PET scans for patients with ENKTL are sparse, but several parameters, such as standardized uptake value (SUVmax), whole-body metabolic tumor volume, and recently, Deauville score have shown good correlation with clinical outcomes. 12,21 In the current study, we applied a Deauville score based on PET/CT to assess tumor response, because it has been reported to be feasible and reproducible, with good interobserver agreement.…”

Section: Discussionmentioning

confidence: 99%

Prognostic relevance of pretransplant Deauville score on PET-CT and presence of EBV DNA in patients who underwent autologous stem cell transplantation for ENKTL

Lim

et al. 2016

Bone Marrow Transplant

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High-dose chemotherapy and autologous stem cell transplantation (ASCT) for extranodal natural killer/T-cell lymphoma (ENKTL) is a reasonable option for a subset of patients. The impact of response status, according to positron emission tomography/computed tomography (PET/CT) results and/or presence of circulating EBV DNA prior to ASCT, has not yet been established. We analyzed 27 ENKTL patients with pre-ASCT circulating EBV DNA who had undergone pre-ASCT PET/CT between 2009 and 2014. We classified patients into two groups based on the result of pretransplantation assessment: a favorable risk group (pretransplant five-point Deauville score (DS) of 1-2 based on PET/CT and no detectable EBV DNA) and an unfavorable risk group (DS 1-2 with detectable EBV DNA, DS 3-5 with or without detectable EBV DNA). After a median follow-up of 37 months, overall survival and PFS were significantly different between the two groups (median OS: not reached for favorable risk group vs 7.0 months for unfavorable risk group, P = 0.017; median PFS: 16.0 vs 5.0 months, P = 0.019). Multivariate analysis revealed that pre-ASCT DS and EBV DNA was the only independent prognostic factor considering stage, IPI and NKPI. Precise assessment of the status of disease before transplantation may provide more benefit from ASCT to ENKTL patients.Bone Marrow Transplantation (2016) 51, 807-812; doi:10.1038/bmt.2016.6; published online 8 February 2016 INTRODUCTIONExtranodal natural killer/T-cell lymphoma (ENKTL) is a rare and distinct subtype of non-Hodgkin lymphoma (NHL), which is characterized by clinically aggressive behavior leading to poor survival among all T-cell lymphoma subtypes. 1 Concurrent chemoradiotherapy (CCRT) followed by chemotherapy has shown promising results with manageable toxicities for localized disease, 2,3 and the application of nonanthracycline-based chemotherapy incorporating L-asparaginase has improved survival outcome of advanced, relapsed or refractory ENKTL patients. [4][5][6] However, treatment failure still occurs frequently, and thus the unmet need persists for additional therapies to improve outcomes for patients with ENKTL. Accordingly, highdose chemotherapy with autologous stem cell transplantation (ASCT) has been evaluated as a consolidation therapy for ENKTL. However, previous studies have failed to clearly determine the efficacy of ASCT, because most of them were retrospective analyses with small sample sizes, and the enrolled patient populations were very heterogeneous, including various transplantation settings. 7-11 Moreover, although previous data showed that disease status at the time of ASCT was the most important prognostic factor for survival and relapse-free survival, 9,11 the optimal response assessment with respect to existing computed tomography (CT) scans, positron emission tomography/computed tomography (PET/CT) findings, and EBV

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“…A transzplantációval összefüggő mortalitás 1,6% volt. A korai stádiumú betegeknél hároméves OS 67,6%, PFS 64,5%, az előrehaladott stádiumú betegeknél OS 52,3%, PFS 40,1%-nak bizonyult [27].…”

Section: Autológ őSsejt-transzplantációunclassified

Nasalis típusú extranodalis natural killer T-sejtes lymphoma hazai előfordulása és kezelésével szerzett tapasztalatok

Bakos

Szomor

Schneider³

et al. 2017

Orvosi Hetilap

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Bevezetés: Az extranodalis nasalis típusú natural killer/T (NK/T) sejtes lymphoma (ENKTL) a T-sejtes lymphomák egyik ritka agresszív megjelenésű formája, amely elsősorban sinonasalis és nasopharynx kiindulású. Bár előfordulása ritka a fejlett nyugati országokban, kezelése a hagyományos, agresszív lymphomákban alkalmazott antraciklintartalmú kemoterápiával csekély hatékonyságú. Célkitűzés: ENKTL-esetek előfordulása hazai hematológiai centrumok által gondozott non-Hodgkin-lymphomás betegek között. Módszer: A szerzők négy magyarországi hematológiai centrumban 2003-2015 között kezelt 20 ENKTL-beteg klinikai adatait elemezték. A betegek között 12 férfi és 8 nő volt, medián életkor 49,5 év (22-84 év). Eredmények: Tíz esetben a betegség lokalizált (I-II. stádiumban) volt a diagnózis idején. Kemoterápiás kezelésben részesült 17 beteg (11 CHOP, CHOP-szerű, kettő hyper-CVAD, egy ProMACECytaBom, egy SMILE, kettő egyéb), amelyet hat esetben érintett mezős besugárzással (IFRT) egészítettek ki (40-46 Gy). Az első vonalbeli kezelésre kilenc beteg komplett (CR), három parciális remisszióba (PR) került, három progrediált, két esetben stabil volt a betegség. A medián követési idő 32 (3-113) hónap volt. Öt beteg progresszió, recidíva miatt második vonalban újabb kezelésben részesült (kettő DHAP, egy VIM, egy hyper-CVAD, egy ProMACECytaBom). Második vonalbeli kezelésre CR nem jött létre egy betegben sem. Két esetben első CR-ben autológ őssejt-transzplantáció történt. Következtetés: Az ENKTL kezelésében hatékonyabbak a nem antraciklintartalmú kemoterápiás kezelések. Elsősorban L-aszparagináz-alapú kombinált kemoterápia és egyidejű vagy szekvenciális kemo-radioterápia alkalmazásával a túl-élés és CR aránya javítható. Orv Hetil. 2017; 158(41): 1635-1641.

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Clinical Outcomes and Prognostic Factors of Up-Front Autologous Stem Cell Transplantation in Patients with Extranodal Natural Killer/T Cell Lymphoma

Cited by 82 publications

References 36 publications

NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018

Prognostic relevance of pretransplant Deauville score on PET-CT and presence of EBV DNA in patients who underwent autologous stem cell transplantation for ENKTL

Nasalis típusú extranodalis natural killer T-sejtes lymphoma hazai előfordulása és kezelésével szerzett tapasztalatok

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