A modified international prognostic index including pretreatment hemoglobin level for early stage extranodal natural killer/T cell lymphoma.

In this study, we investigated the prognostic role of pretreatment hemoglobin level in 321 patients with stage I/II extranodal natural killer (NK/T cell lymphoma (ENKTL). Patients with pretreatment hemoglobin level < 120 g/L had significantly inferior progression-free survival (PFS) and overall survival (OS) than those with hemoglobin level ≥ 120 g/L (p < 0.05). In a multivariate Cox regression model, age, Eastern Cooperative Oncology Group (performance status), lactate dehydrogenase level, Ann Arbor stage and pretreatment hemoglobin level were all independent prognostic factors for PFS and OS (p < 0.05). Using these five parameters, a modified international prognostic index (mIPI) model was constructed. This mIPI could categorize three groups with significantly different PFS and OS (both p < 0.0001) in both the training set and the validation set. In conclusion, this study confirmed the prognostic role of pretreatment hemoglobin level in ENKTL, and a newly modified IPI including pretreatment hemoglobin level could be used to further optimize treatments for patients with stage I/II ENKTL, especially in the era of asparaginase.