Abnormal pretreatment coagulation factor levels correlate with poor prognosis in patients with early-stage extranodal na
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ORIGINAL ARTICLE
Abnormal pretreatment coagulation factor levels correlate with poor prognosis in patients with early-stage extranodal nasal-type natural/killer T cell lymphoma Yue Chai 1 & Fei Qi 1 & Bo Chen 1 & Lin Gui 1 & Jianliang Yang 1 & Shunan Qi 1 & Yongwen Song 1 & Yexiong Li 1 & Yuce Wei 1 & Mei Dong 1 Received: 14 December 2019 / Accepted: 10 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Coagulative dysfunction is frequently observed among patients with extranodal nasal-type natural killer/T cell lymphoma (NKTCL) in our clinical practice. However, the true prognostic value of coagulation factors in patients with NKTCL has not been evaluated systemically. Data for patients with stage I/II NKTCL who were treated in the Cancer Hospital, Chinese Academy of Medical Sciences, from January 2008 to January 2019 were collected retrospectively. The patients enrolled in this study were initially diagnosed as having early-stage disease. The patients’ baseline characteristics and pretreatment laboratory tests for coagulation function, including fibrinogen (FIB) and D-dimer (D-D), were reviewed and analyzed. The influence of coagulative factors on the responses and prognosis of patients with early-stage NKTCL was evaluated. Among 394 patients assessed, 154 were included in this study. Abnormal coagulation function was found in nearly half of the patients (48.1%). Univariate analysis showed that reduced complete remission (CR) was associated with elevated D-D (P = 0.001) and elevated FIB levels (P = 0.006). The D-D level was demonstrated as associated with unfavorable progression-free survival (PFS) (P = 0.003) and overall survival (OS) (P = 0.002). Multivariate analysis indicated that an elevated D-D level was an independent factor for poor clinical response (P = 0.019), PFS (P = 0.046), and OS (P = 0.024). Elevated pretreatment levels of coagulation factors, especially D-D and plasma FIB, are unfavorable predictors for clinical response, OS, and PFS in early-stage NKTCL. Keywords Coagulation function . Extranodal nasal-type natural killer/T cell lymphoma . Prognostic marker . Survival
Introduction Extranodal nasal-type natural/killer T cell lymphoma (NKTCL) is a subtype of non-Hodgkin’s lymphoma, which is derived from NK cells or T cells. The primary sites in which NKTCL usually arises include the upper aerodigestive tract and extra-upper aerodigestive tract. NKTCL features a geographical bias toward Asia and Latin America, with a poor prognosis and an aggressive clinical course. Yang et al. [1] reported that 70 to 90% of the 1383 patients with NKTCL treated at 10 institutions in China between 2000 and 2011
* Mei Dong [email protected] 1
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
had early-stage disease. The 5-year OS rate for early-stage patients ranges from 30 to 90%,
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