Absolute lymphocyte count is a novel prognostic indicator in extranodal natural killer/T-cell lymphoma, nasal type.
BACKGROUND
extranodal natural killer (NK)/T-cell lymphoma (ENKL) is a heterogeneous entity with poor survival, requiring risk stratification in affected patients. We proposed absolute lymphocyte count (ALC) as a new prognostic factor in ENKL.


METHODS
we retrospectively analyzed 128 patients newly diagnosed with ENKL. Independent prognostic factors of survival were determined by Cox regression analysis.


RESULTS
patients with low ALC (<1.0 × 10(9)/l) at diagnosis tended to have more adverse clinical features. Patients with high ALC (≥1.0 × 10(9)/l) at diagnosis had better overall survival (OS; P < 0.0001) and progression-free survival (PFS; P<0.0001), and achieved higher complete remission rates (P=0.001). Multivariate analysis with known prognostic factors showed that ALC, B symptoms and advanced stage were independent predictors for OS and PFS. Using the International Prognostic Index, Prognostic Index for Peripheral T-cell lymphoma unspecified, or Korean Prognostic Index for nasal NK/T-cell lymphoma, the majority of patients were in the low-risk category (with no or one adverse factor). ALC was helpful to differentiate the low-risk patients with different survival outcomes (P < 0.0001).


CONCLUSIONS
our data suggest that ALC at diagnosis is a novel, powerful predictor of prognosis in ENKL. Immune status at diagnosis might have an important influence on survival in patients with ENKL.
Huang
J J
JJ
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology.
Jiang
W Q
WQ
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology.
Lin
T Y
TY
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology.
Huang
Y
Y
State Key Laboratory of Oncology in Southern China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China.
Xu
R H
RH
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology.
Huang
H Q
HQ
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology.
Li
Z M
ZM
State Key Laboratory of Oncology in Southern China; Department of Medical Oncology. Electronic address: lzmlzmlzm@yahoo.com.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D054391:Lymphoma, Extranodal NK-T-Cell / Q000097:blood*; D016399:Lymphoma, T-Cell / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult