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Survival outcomes of patients with extranodal natural-killer T-cell lymphoma: a prospective cohort study from the international T-cell Project.
The Lancet Haematology ( IF 24.7 ) Pub Date : 2020-02-24 , DOI: 10.1016/s2352-3026(19)30283-2
Christopher P Fox 1 , Monica Civallero 2 , Young-Hyeh Ko 3 , Martina Manni 2 , Tetiana Skrypets 2 , Stefano Pileri 4 , Seok Jin Kim 5 , Maria Elena Cabrera 6 , Andrei R Shustov 7 , Carlos S Chiattone 8 , Steven M Horwitz 9 , Ivan Dlouhy 10 , Michele Spina 11 , Felicitas Hitz 12 , Silvia Montoto 13 , Arnon Nagler 14 , Virginia Martinez 15 , Carmino A De Souza 16 , Ruben Fernandez-Alvarez 17 , Veronika Ballova 18 , Raul Gabús 19 , Giorgio Inghirami 20 , Massimo Federico 2 , Won Seog Kim 5
Affiliation  

BACKGROUND Extranodal natural killer (NK) T-cell lymphoma (ENKTL) is a unique clinicopathological entity, typically associated with poor survival outcomes. Most published data have come from east Asian study groups, with little information available from international cohorts. The effects of treatment advances on routine clinical practice across continental territories has not been clear. We aimed to improve understanding of the clinical characteristics and outcomes of patients with ENKTL. METHODS We did a substudy of patients with ENKTL from the T-cell Project, a global prospective cohort study. The T-cell Project registered consecutively diagnosed adults (>18 years) with newly diagnosed, untreated mature T-cell or NK lymphomas (WHO 2001 or 2008 classifications) from 74 centres in 13 countries (in Asia, Europe, North America, and South America). In total, 1695 patients with mature T-cell or NK lymphomas were enrolled between Oct 12, 2006 and Feb 28, 2018 in the T-cell Project. The first patient with ENKTL was enrolled on Feb 15, 2007, and the last on May 26, 2017. Data on baseline characteristics, first-line treatment, treatment response, and survival outcomes were recorded in a central database (locked March 30, 2019). The primary outcome was 5-year overall survival. The T-cell Project is registered on ClinicalTrials.gov, NCT01142674. FINDINGS 166 patients were diagnosed with ENKTL, comprising 11% of 1553 eligible registered cases and distributed across 40 participating centres in four continents. At a median follow-up of 44 months (IQR 20-61), overall survival at 5 years was 54% (95% CI 44-63) in patients with nasal disease (n=98) and 34% (27-46) in patients with extranasal disease (n=68). INTERPRETATION To our knowledge, this study presents the largest international cohort of patients with ENKTL. We describe a clinically significant improvement in the survival of patients with ENKTL treated in routine clinical practice over the past decade, likely to be attributable to the increasing use of treatment protocols specific for ENKTL. FUNDING The Fondazione Cassa di Risparmio di Modena, the Associazione Angela Serra per la Ricerca sul Cancro, the Fondazione Italiana Linfomi, Allos Therapeutics, Spectrum Pharmaceuticals, Associazione Italiana per la Ricerca sul Cancro, and the National Cancer Institute at the National Institutes of Health.

中文翻译:

结外自然杀伤性T细胞淋巴瘤患者的生存结局:一项来自国际T细胞计划的前瞻性队列研究。

背景结外自然杀伤(NK)T细胞淋巴瘤(ENKTL)是独特的临床病理学实体,通常与不良的生存结果相关。大多数公开的数据来自东亚研究小组,而来自国际同类研究的信息很少。治疗进展对整个大陆领土的常规临床实践的影响尚不清楚。我们旨在增进对ENKTL患者临床特征和结局的了解。方法我们对全球前瞻性队列研究T细胞项目的ENKTL患者进行了一项子研究。T细胞计划在来自13个国家(亚洲,欧洲,北美,美国,和南美)。在2006年10月12日至2018年2月28日之间,共有1695例患有成熟T细胞或NK淋巴瘤的患者入选T细胞计划。首位ENKTL患者于2007年2月15日入选,最后一位于2017年5月26日入选。有关基线特征,一线治疗,治疗反应和生存结果的数据记录在中央数据库中(2019年3月30日锁定) )。主要结局是5年总生存期。T细胞项目已在ClinicalTrials.gov上注册为NCT01142674。结果166例患者被诊断出患有ENKTL,占1553例合格注册病例的11%,分布在四大洲的40个参与中心。在平均随访44个月(IQR 20-61)中,鼻病患者(n = 98)的5年总生存率为54%(95%CI 44-63),鼻外疾病患者(n = 68)的34%(27-46)。解释据我们所知,本研究介绍了国际上最大的ENKTL患者队列。我们描述了过去十年中常规临床实践中治疗的ENKTL患者生存率的临床显着改善,这可能归因于对ENKTL特有的治疗方案的使用增加。资金筹措摩德纳的卡萨迪里斯帕尔皮奥·迪莫纳基金会,Cancro的安哥拉·拉塞拉协会,Canos的意大利Fondazione Italiana Linfomi,Allos Therapeutics,Spectrum Pharmaceuticals,Cancro的意大利药业协会和国立卫生研究院的国家癌症研究所。解释据我们所知,本研究介绍了国际上最大的ENKTL患者队列。我们描述了过去十年中常规临床实践中治疗的ENKTL患者生存率的临床显着改善,这可能归因于对ENKTL特有的治疗方案的使用增加。资金筹措摩德纳的卡萨迪里斯帕尔皮奥·迪莫纳基金会,Cancro的安哥拉·拉塞拉协会,Canos的意大利Fondazione Italiana Linfomi,Allos Therapeutics,Spectrum Pharmaceuticals,Cancro的意大利药业协会和国立卫生研究院的国家癌症研究所。解释据我们所知,本研究介绍了国际上最大的ENKTL患者队列。我们描述了过去十年中常规临床实践中治疗的ENKTL患者生存率的临床显着改善,这可能归因于对ENKTL特有的治疗方案的使用增加。资金筹措摩德纳的卡萨迪里斯帕尔皮奥·迪莫纳基金会,Cancro的安哥拉·拉塞拉协会,Canos的意大利Fondazione Italiana Linfomi,Allos Therapeutics,Spectrum Pharmaceuticals,Cancro的意大利药业协会和国立卫生研究院的国家癌症研究所。我们描述了过去十年中常规临床实践中治疗的ENKTL患者生存率的临床显着改善,这可能归因于对ENKTL特有的治疗方案的使用增加。资金筹措摩德纳基金会基金会,坎德拉市的安吉拉·塞拉·拉·坎克罗,义大利·洛芬米基金会,Allos Therapeutics,Spectrum Pharmaceuticals,坎德拉市的意大利拉各斯协会和美国国立卫生研究院的国立癌症研究所。我们描述了过去十年中常规临床实践中治疗的ENKTL患者生存率的临床显着改善,这可能归因于对ENKTL特有的治疗方案的使用增加。资金筹措摩德纳的卡萨迪里斯帕尔皮奥·迪莫纳基金会,Cancro的安哥拉·拉塞拉协会,Canos的意大利Fondazione Italiana Linfomi,Allos Therapeutics,Spectrum Pharmaceuticals,Cancro的意大利药业协会和国立卫生研究院的国家癌症研究所。
更新日期:2020-02-25
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