Journal
LEUKEMIA
Volume 35, Issue 6, Pages 1671-1682Publisher
SPRINGERNATURE
DOI: 10.1038/s41375-020-01042-y
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Funding
- National Natural Science Foundation of China [81670185]
- Chinese Academy of Medical Science (CAMS)
- Innovation Fund for Medical Sciences (CIFMS) [2016-I2M-1-001]
- National Key Projects of Research and Development of China [2016YFC0904600]
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Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of ENKTCL. Analysis of a large cohort revealed that patients achieving PFS24 had a higher overall survival rate than those who did not, suggesting PFS24 may be useful for study design and risk stratification in ENKTCL.
Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of extranodal NK/T-cell lymphoma (ENKTCL) in the modern era. We aim to analyze progression-free survival at 24 months (PFS24) and subsequent overall survival (OS) in a large-scale multicenter cohort of patients. 1790 patients were included from the China Lymphoma Collaborative Group (CLCG) database. Subsequent OS was defined from the time of PFS24 or progression within 24 months to death. OS was compared with age- and sex-matched general Chinese population using expected survival and standardized mortality ratio (SMR). Patients who did not achieve PFS24 had a median OS of 5.3 months after progression, with 5-year OS rate of 19.2% and the SMR of 71.4 (95% CI, 62.9-81.1). In contrast, 74% patients achieved PFS24, and the SMR after achieving PFS24 was 1.77 (95% CI, 1.34-2.34). The observed OS rate after PFS24 versus expected OS rate at 5 years was 92.2% versus 94.3%. Similarly, superior outcomes following PFS24 were observed in early-stage patients (5-year OS rate, 92.9%). Patients achieving PFS24 had excellent outcome, whereas patients exhibiting earlier progression had a poor survival. These marked differences suggest that PFS24 may be used for study design and risk stratification in ENKTCL.
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