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Bone Marrow Transplantation (2016) 51, 807812 2016 Macmillan Publishers Limited All rights reserved 0268-3369/16
http://www.nature.com/bmt
Web End =www.nature.com/bmt
SH Lim1, SH Hyun2, HS Kim1, JY Lee1, KH Yoo1, KS Jung1, H-N Song1, J Cho1, S Park1, YH Ko3, SJ Kim1, JY Choi2 and WS Kim1
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 classied patients into two groups based on the result of pretransplantation assessment: a favorable risk group (pretransplant ve-point Deauville score (DS) of 12 based on PET/CT and no detectable EBV DNA) and an unfavorable risk group (DS 12 with detectable EBV DNA, DS 35 with or without detectable EBV DNA). After a median follow-up of 37 months, overall survival and PFS were signicantly 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
Bone Marrow Transplantation (2016) 51, 807812; doi:http://dx.doi.org/10.1038/bmt.2016.6
Web End =10.1038/bmt.2016.6 ; published online 8 February 2016
INTRODUCTION
Extranodal 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.46 However, treatment failure still occurs frequently, and thus the unmet need persists for additional therapies to improve outcomes for patients with ENKTL. Accordingly, high-dose 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 efcacy of ASCT, because most...