■结外NK/T细胞淋巴瘤(ENKTCL),非霍奇金淋巴瘤,以其对鼻结构的破坏性局部影响和炎性细胞因子的全身诱导而闻名。放疗和非蒽环类化疗的同时治疗提高了局部疾病阶段患者的生存率。然而,晚期和复发或难治性(R/R)病例的生存结局差异显著.
■因此,我们使用随机效应模型进行了荟萃分析,以评估晚期或R/RENKTCL的预后因素,由于缺乏针对这些患者的已发表前瞻性试验,因此在Kaplan-Meier图形上使用数字提取器。
■我们观察到接受L天冬酰胺酶治疗的晚期ENKTCL患者的中位无进展生存期(PFS)为14.3个月,总生存期(OS)为19个月。在R/RENKTCL中,PFS和OS分别为11.7和15.6个月,分别。此外,天冬酰胺酶组晚期ENKTCL的OS结局优于非天冬酰胺酶组,PEG-天冬酰胺酶与使用L天冬酰胺酶相比显示出更好的结果。治疗前血液中的EB病毒(EBV)-DNA阳性与晚期ENKTCL的不良结局相关,在R/RENKTCL和治疗后EBV病毒血症患者中观察到类似的趋势。
■集体,这些研究结果表明,在晚期或R/RENKTCL中,使用Las门冬酰胺酶或PEG-天冬酰胺酶的化疗可提高生存率.然而,必须制定有效抑制EBV病毒血症并实现对肿瘤根除的深层反应的未来策略.
UNASSIGNED: Extranodal NK/T-cell lymphoma (ENKTCL), a non-Hodgkin lymphoma, is known for its destructive local impact on nasal structures and systemic induction of inflammatory cytokines. Concurrent treatment with radiation and nonanthracycline- based chemotherapy has improved survival rates in patients with localized disease stages. However, survival outcomes vary significantly in
advanced-stage and relapsed or refractory (R/R) cases.
UNASSIGNED: Therefore, we conducted a meta-analysis using random effects models to assess prognostic factors in
advanced or R/R ENKTCL, employing a digital extractor on Kaplan-Meier graphs owing to the scarcity of published prospective trials for these patients.
UNASSIGNED: We observed that patients with
advanced ENKTCL treated with Lasparaginase had a median progression-free survival (PFS) of 14.3 months and an overall survival (OS) of 19 months. In R/R ENKTCL, PFS and OS were 11.7 and 15.6 months, respectively. Additionally, OS outcomes in
advanced-stage ENKTCL were better in the asparaginase group than that in the non-asparaginase group, with PEG-asparaginase showing superior results compared with that using Lasparaginase. Epstein-Barr Virus (EBV)-DNA positivity in the bloodstream prior to treatment was associated with poor outcomes in advanced-stage ENKTCL, and similar trends were observed in patients with R/R ENKTCL and post-treatment EBV viremia.
UNASSIGNED: Collectively, these findings suggest that chemotherapy with Lasparaginase or PEG-asparaginase can enhance survival in
advanced or R/R ENKTCL. However, future strategies must be developed to effectively suppress EBV viremia and achieve a deep response toward tumor eradication.