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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

Authors
Yhim, Ho-YoungKim, Jin SeokMun, Yeung-ChulMoon, Joon HoChae, Yee SooPark, YongJo, Jae-CheolKim, Seok JinYoon, Dok HyunCheong, June-WonKwak, Jae-YongLee, Je-JungKim, Won SeogSuh, CheolwonYang, Deok-Hwan
Issue Date
9월-2015
Publisher
ELSEVIER SCIENCE INC
Keywords
Autologous; Stem cell transplantation; Extranodal natural killer/T cell lymphoma; Ann Arbor stage; Prognosis
Citation
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, v.21, no.9, pp.1597 - 1604
Indexed
SCIE
SCOPUS
Journal Title
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume
21
Number
9
Start Page
1597
End Page
1604
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/92680
DOI
10.1016/j.bbmt.2015.05.003
ISSN
1083-8791
Abstract
Limited data exist on up-front autologous stem cell transplantation (ASCT) in extranodal natural killer/T cell lymphoma (ENKTL). Sixty-two patients (43 men and 19 women) with newly diagnosed ENKTL who underwent up-front ASCT after primary therapy were identified. Poor-risk characteristics included advanced stage (50%), high-intermediate to high-risk International Prognostic Index (25.8%), and group 3 to 4 of NK/T Cell Lymphoma Prognostic Index (NKPI, 67.7%). Pretransplant responses included complete remission in 61.3% and partial remission in 38.7% of patients, and final post-transplantation response included complete remission in 78.3%. Early progression occurred in 12.9%. At a median follow-up of 43.3 months (range, 3.7 to 114.6), 3-year progression-free survival (PFS) was 52.4% and 3-year overall survival (OS) was 60.0%. Patients with limited disease had significantly better 3-year PFS (64.5% versus 40.1%, P = .017) and OS (67.6% versus 52.3%, P = .048) than those with advanced disease. Multivariate analysis showed NKPI and pretransplant response were independent prognostic factors influencing survival, particularly NKPI in limited disease and pretransplant response in advanced disease. Radiotherapy was an independent factor for reduced progression and survival in patients with limited disease, but anthracycline-based chemotherapy was a poor prognostic factor for progression in patients with advanced disease. Up-front ASCT is an active treatment in ENKTL patients responding to primary therapy. 2015 American Society for Blood and Marrow Transplantation.
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