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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Hematologic Malignancies
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1362367

Advanced, Relapse/Refractory ENKTCL

Provisionally accepted
Tong Yoon Kim Tong Yoon Kim 1Tae J. Kim Tae J. Kim 2Eun J. Han Eun J. Han 3Gi J. Min Gi J. Min 4Youngwoo Jeon Youngwoo Jeon 1Seok-Goo Cho Seok-Goo Cho 4*
  • 1 Department of Hematology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea
  • 2 Department of Hospital Pathology, Yeouido St. Mary's hospital, The Catholic University of Korea, Seoul, Republic of Korea, Seoul, Republic of Korea
  • 3 Division of Nuclear Medicine, Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea
  • 4 Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Extranodal NK/T-cell lymphoma (ENKTCL), a non-Hodgkin T-cell lymphoma, is known for its destructive local impact on nasal structures and systemic induction of inflammatory cytokines. Concurrent treatment with radiation and non-anthracycline-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. 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. We observed that patients with advanced ENKTCL treated with L-asparaginase 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 nonasparaginase group, with PEG-asparaginase showing superior results compared with that using L-asparaginase. 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. Collectively, these findings suggest that chemotherapy with L-asparaginase 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.

    Keywords: Extranodal NK/T-cell lymphoma, Advanced, Relapsed/refractory, Estimate individual patient data, Meta-analysis, Epstein-Barr virus

    Received: 28 Dec 2023; Accepted: 15 Jul 2024.

    Copyright: © 2024 Kim, Kim, Han, Min, Jeon and Cho. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Seok-Goo Cho, Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Seoul, Republic of Korea

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