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A prognostic survival nomogram for persons with extra-nodal natural killer-/T-cell lymphoma

Leukemia volume 36, pages 2724–2728 (2022)Cite this article

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Extra-nodal natural killer (NK)-/T-cell lymphoma (eNKTL) is an uncommon Epstein-Barr virus (EBV)-associated lymphoma often starting in nasopharynx and endemic in Asia and South America [1]. It has been re-classified in the upcoming 5th Edition of the WHO Classification of Haematolymphoid Tumors: Lymphoid Neoplasms. Therapy of eNKTL involves radiation therapy with/without anti-cancer drugs including, most recently, L-asparaginase.

Predicting survival of persons with eNKTL and/or choosing appropriate therapies requires an accurate prognostic model/score. Several such models/scores include the International Prognostic Index (IPI), the Korean Prognostic Index (KPI), the Prognostic Index of Natural Killer Lymphoma with or without EBV DNA (PINK/PINK-E) and the nomogram-revised risk index (NRI) [1,2,3,4]. The IPI and KPI were developed in subjects receiving modern therapy(ies) [2, 3]. PINK-E is the only model using data of EBV DNA copy number [1]. None used data from maximum standardized uptake values (SUVmax) in 18FDG positron emission computed tomography (PET/CT) which is a validated prognostic/predictive co-variate [5].

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Fig. 1: Construction and validation of the survival Nomogram-ES.

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Funding

YL is supported by Sun Yat-sen University Start-Up Funding grant 201603, the Program for Guangdong Introducing Innovative and Entrepreneurial Teams (2017ZT07S096) and National Natural Science Foundation of China grant 81873428. HW is supported by National Natural Science Foundation of China grant 81700148 and Natural Science Foundation of Guangdong Province grant 2021A1515010093. RPG acknowledges support from the National Institute of Health Research (NIHR) Biomedical Research Center funding scheme. Y.L. and R.P.G. acknowledges support funding from Ministry of Science and Technology of China (84000-51200002).

Author information

Author notes

  1. These authors contributed equally: Hua Wang, Bi-bo Fu, Zhi-jun Wuxiao, Ya-jun Li, Li Huang, Jie Ma.

Authors and Affiliations

  1. Department of Hematologic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, PR China

    Hua Wang, Bi-bo Fu, Robert Peter Gale, Zhong-jun Xia & Yang Liang

  2. Department of Hematology, Lymphoma and Myeloma Center, HMC Cancer Institute, The First Affiliated Hospital of Hainan Medical University, Haikou City, Hainan, PR China

    Zhi-jun Wuxiao & Cai-bo Fu

  3. Department of Lymphoma and Hematology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, PR China

    Ya-jun Li

  4. Department of Hematology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, PR China

    Li Huang & Jing Guo

  5. Department of Medical Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China

    Jie Ma & Sheng-sheng Zhou

  6. Department of Hematology, The Second Hospital of Anhui Medical University, Hefei, Anhui, PR China

    Zhi-min Zhai, Fan Wu & Juan Wang

  7. Department of Hematology, Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, PR China

    Yuan-bin Wu

  8. Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, PR China

    Zhen-shu Xu

  9. Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, PR China

    Jia Feng

  10. Department of Hematology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University), Shenzhen, PR China

    Ting-ting Chen

  11. Cancer Center, Affiliated Hospital, Guangdong Medical University, Zhanjiang, Guangdong, PR China

    Xing-gui Chen

  12. Department of Hematology, Huizhou Municipal Central Hospital, Huizhou, Guangdong, PR China

    Guo-wei Li

  13. Department of Medical Hematology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangdong gastrointestinal hospital, Guangzhou, Guangdong, PR China

    Ting-zhi Liu

  14. Department of Hematology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, PR China

    Hai-bin Huang

  15. Department of Hematology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, PR China

    Run-hui Zheng

  16. Department of Hematology, General Hospital of Southern Theater Command, PLA, Guangzhou, Guangdong, PR China

    Yong-hua Li

  17. The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, PR China

    Hong-fang Tao

  18. Department of Hematology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, PR China

    Fu-ming Zi

  19. Department of Hematology, The First Affiliated Hospital of Jinan university, Guangzhou, Guangdong, PR China

    Hui Zeng

  20. Haematology Research Centre, Department of Immunology and Inflammation, Imperial College London, London, UK

    Robert Peter Gale

Authors
  1. Hua Wang
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Contributions

YL, HW, ZJX and RPG designed the study. HW, BBF, ZJWX, YJL, LH, JM, ZMZ, JG, YBW, ZSX, JF, SSZ, TTC, XGC, GWL, TZL, HBH, RHZ, YHL, HFT, FMZ, FW, JW, HZ, CBF, ZJX, YL collected and assembled of data. HW, BBF, ZJWX, YJL, LH and JM analyzed and interpretated the data. HW and BBF drafted the paper. YL, RPG and HW revised the typescript. All authors approved the typescript, take responsibility for the content and approved to submit for publication.

Corresponding authors

Correspondence to Zhong-jun Xia or Yang Liang.

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Competing interests

RPG is a consultant to NexImmune Inc. and Ananexa Pharma Ascentage Pharm Group, Antengene Biotech LLC, Medical Director, FFF Enterprises Inc.; partner, AZAC Inc.; Board of Directors, Russian Foundation for Cancer Research Support; and Scientific Advisory Board: StemRad Ltd. The other authors declare no competing interests.

Ethics approval

The study was approved by the Ethics Committee and Institutional Review Board of Sun Yat-Sen University Cancer Center (SZR2020-083) compliant with the principles of the Helsinki Declaration.

Informed consent

The requirement for subject informed consent was waived because the study was retrospective and data were anonymized.

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Wang, H., Fu, Bb., Wuxiao, Zj. et al. A prognostic survival nomogram for persons with extra-nodal natural killer-/T-cell lymphoma. Leukemia 36, 2724–2728 (2022). https://doi.org/10.1038/s41375-022-01679-x

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