N Nora Bennani1, Aung M Tun2, Kenneth R Carson3, Jessica L Geiger4, Lauren S Maeda5, Kerry J Savage6, Jim Rose6, Lauren Pinter-Brown7, Matthew A Lunning8, Jeremy S Abramson9, Nancy L Bartlett10, Julie M Vose8, Andrew M Evens11, Sonali M Smith12, Steven M Horwitz13, Stephen M Ansell4, Ranjana H Advani5. 1. Division of Hematology, Mayo Clinic, Rochester, MN. Electronic address: bennani.nora@mayo.edu. 2. Division of Hematology, Mayo Clinic, Rochester, MN; Division of Hematologic Malignancies and Cellular Therapeutics, University of Kansas Cancer Center, Kansas City, KS. 3. Research Service, St Louis Veterans Affairs Medical Center, St Louis, MO; Division of Oncology, Washington University School of Medicine, St. Louis, MO. 4. Division of Hematology, Mayo Clinic, Rochester, MN. 5. Division of Oncology, Stanford Cancer Institute, Stanford, CA. 6. Department of Medical Oncology, Centre for Lymphoid Cancer, Vancouver, BC, Canada. 7. Divisions of Hematology/Oncology, UCLA, Los Angeles, CA. 8. Divisions of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE. 9. Divisions of Hematology/Oncology, Massachusetts General Hospital Cancer Center, Boston, MA. 10. Division of Oncology, Washington University School of Medicine, St. Louis, MO. 11. U Mass Memorial Cancer Center, Worcester, MA. 12. Divisions of Hematology/Oncology, University of Chicago, Chicago, IL. 13. Division of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.
Abstract
BACKGROUND: Extranodal natural killer/T-cell lymphoma (ENKTL) is rare and clinicaldata from non-Asian countries are lacking. It is unclear whether outcomes and diseasenatural history is similar to reported Asian series. We assessed characteristics and outcomes of patients with ENKTL from major North American centers. PATIENTS AND METHODS: We retrospectively identified patients with newly-diagnosedCD56 + ENKTL and studied disease characteristics and clinical outcomes. RESULTS: 121 patients with ENKTL diagnosed between June 1990 and November 2012 were identified. Eighty-three patients (69%) had stage I/II disease and were treatedwith combined modality therapy (CMT) (n=53), chemotherapy alone (CT) (n=14) orradiotherapy alone (RT) (n=16). Thirty-eight patients (31%) had stage III/IV diseaseand were treated with CMT (n=12), CT (n=23), or RT (n=3). The median follow-up forthe entire cohort was 51 months. Patients with stage I/II disease, compared to thosewith stage III/IV disease, had superior 2-year progression free survival (PFS) 43% vs19% (p=0.03) and overall survival (OS) 59% vs 29% (p=0.004). Outcomes were similarfor stage I/II patients who received CMT vs RT alone with 2-year PFS (53% vs 47%;p=0.91) and OS (67% vs 67%; p=0.58). No significant differences in outcomes werenoted based on race/ethnicity. CONCLUSIONS: This 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.
BACKGROUND: Extranodal natural killer/T-cell lymphoma (ENKTL) is rare and clinicaldata from non-Asian countries are lacking. It is unclear whether outcomes and diseasenatural history is similar to reported Asian series. We assessed characteristics and outcomes of patients with ENKTL from major North American centers. PATIENTS AND METHODS: We retrospectively identified patients with newly-diagnosedCD56 + ENKTL and studied disease characteristics and clinical outcomes. RESULTS: 121 patients with ENKTL diagnosed between June 1990 and November 2012 were identified. Eighty-three patients (69%) had stage I/II disease and were treatedwith combined modality therapy (CMT) (n=53), chemotherapy alone (CT) (n=14) orradiotherapy alone (RT) (n=16). Thirty-eight patients (31%) had stage III/IV diseaseand were treated with CMT (n=12), CT (n=23), or RT (n=3). The median follow-up forthe entire cohort was 51 months. Patients with stage I/II disease, compared to thosewith stage III/IV disease, had superior 2-year progression free survival (PFS) 43% vs19% (p=0.03) and overall survival (OS) 59% vs 29% (p=0.004). Outcomes were similarfor stage I/II patients who received CMT vs RT alone with 2-year PFS (53% vs 47%;p=0.91) and OS (67% vs 67%; p=0.58). No significant differences in outcomes werenoted based on race/ethnicity. CONCLUSIONS: This 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.
Authors: R Suzuki; J Suzumiya; M Yamaguchi; S Nakamura; J Kameoka; H Kojima; M Abe; T Kinoshita; T Yoshino; K Iwatsuki; Y Kagami; T Tsuzuki; M Kurokawa; K Ito; K Kawa; K Oshimi Journal: Ann Oncol Date: 2009-10-22 Impact factor: 32.976