KMID : 0939920230550010314
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´ëÇѾÏÇÐȸÁö 2023 Volume.55 No. 1 p.314 ~ p.324
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A New Prognostic Index for Extranodal Natural Killer/T-Cell Lymphoma: Incorporation of Serum ¥â-2 Microglobulin to PINK
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Kang So-Ra
Cho Hyung-Woo Kim Shin Lee Kyoung-Min Kang Eun-Hee Park Jung-Sun Lee Yoon-Se Park Chan-Sik Ko Hyun-Jung Huh Joo-Ryung Ryu Jin-Sook Lee Sang-Wook Kim Suk-Jin Kim Won-Seog Yoon Sang-Eun Ko Young-Hyeh Suh Cheol-Won
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Abstract
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Purpose : Prognostic Index for Natural Killer Lymphoma (PINK) is the most widely accepted prognostic model for patients with extranodal natural killer/T-cell lymphoma (ENKTL) treated with non-anthracycline?based therapy. We aimed to evaluate the prognostic implications of serum ¥â-2 microglobulin (¥â2M) in the context of PINK and proposed a new prognostic model.
Materials and Methods : A total of 138 patients who were newly diagnosed with ENKTL and treated with non-anthracycline-based chemotherapy were identified. The cut-off value of high serum ¥â2M was calculated by maximal-chi square methods (4.1 mg/L). A new prognostic model incorporating serum ¥â2M into PINK was proposed and validated in an independent validation cohort (n=88).
Results : The patients¡¯ median age was 53.5 years (range, 19 to 80 years). Patients with high serum ¥â2M levels had significantly worse overall survival (OS) and progression-free survival (PFS). In multivariate analysis, high serum ¥â2M was an independent adverse prognostic factor for OS. A new PINK-B (Prognostic Index for Natural Killer Lymphoma-serum ¥â-2 microglobulin) model stratified patients into three groups with distinct OS and PFS in the training cohort (3-year OS, 84.1% [95% confidence interval, 75.1 to 94.2], 46.8% [36.1 to 60.8] and 17.6% [6.3 to 49.2] for the low-, intermediate, and high-risk groups, respectively; 3-year PFS, 70.6% [59.4 to 83.8], 35.9% [25.9 to 49.8], and 7.35% [1.1 to 46.7] for the low-, intermediate-, and high-risk groups, respectively). The PINK-B model was further validated in an independent cohort.
Conclusion : Serum ¥â2M is an independent prognostic factor for ENKTL patients. The new serum ¥â2M-based prognostic model may be useful for identifying ultra-high-risk patients, and it can easily be adopted into daily clinical practice.
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KEYWORD
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Extranodal natural killer/T-cell lymphoma, ¥â-2 microglobulin, Prognostic index, PINK, PINK-B
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