CLINICOPATHOLOGICAL ANALYSIS OF T-CELL AND NK-CELL NEOPLASMS BASED ON THE 4TH EDITION OF THE WORLD HEALTH ORGANIZATION CLASSIFICATION

ARIIZUMI Hirotsugu, SHIOZAWA Eisuke, HOMMA Mayumi, YAMOCHI-ONIZUKA Toshiko, TAKIMOTO Masafumi, OTA Hidekazu, HATTORI Norimichi, MAEDA Takashi, NAKASHIMA Hidetoshi, SAITO Bungo, YANAGISAWA Kouji, MATSUDA Isao, NAKAMAKI Tsuyoshi, TOMOYASU Shigeru

doi:10.14930/jsma.70.399

We retrospectively studied the clinicopathological factors of patients with T- and NK-cell neoplasms (T/NK-N) based on the 4th edition of the World Health Organization classification of tumors of hematopoietic and lymphoid tissues in Showa University Hospital. This study included 107 patients with T/NK-N, including 25 (23.4%) with peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS); 19 (17.8%) with adult T-cell leukemia/lymphoma (ATLL); 17 (15.9%) with extranodal NK/T cell lymphoma, nasal type (ENKTL); 10 (9.3%) with angioimmunoblastic T-cell lymphoma (AITL); 9 (8.4%) with primary cutaneous CD30 positive T-cell lymphoproliferative disorders (C-CD30 + LPD); 8 (7.5%) with T lymphoblastic leukemia/lymphoma (T-ALL/LBL); 8 (7.5%) with mycosis fungoides (MF); 4 (3.7%) with anaplastic large cell lymphoma, ALK negative (ALCL, ALK-); and 7 with others. Among all analyzable patients, the 5-year overall survival (OS) rate was 41% and the median duration of OS was 34.8 months. Patients with C-CD30 + LPD had significantly longer survival rates than those with ATLL and AITL. Patients with a level of serum-soluble interleukin-2 receptor (sIL-2R) 1300 U/mL at diagnosis had significantly lower survival rates (P = 0.02). With the exception of ATLL patients, high sIL-2R level at diagnosis was significantly associated with reduced survival (P = 0.02). sIL-2R levels at diagnosis were lower in patients with ENKTL, C-CD30 + LPD, ALCL, ALK-, MF, and T-ALL/LBL than in those with other subtypes. At diagnosis, serum iron levels below the normal range (male, 50 μg/dL; female, 35 μg/dL) and total iron-binding capacity < 250 μg/dL were significantly associated with reduced survival (P = 0.02). Our study suggests that high sIL-2R levels and iron restriction at diagnosis are poor prognostic factors. To date, there have been no reports on the correlation of iron restriction and T/NK-N. In order to establish a prognostic model including parameters of iron metabolism, a greater number of patients should be evaluated in larger clinical trials.

CLINICOPATHOLOGICAL ANALYSIS OF T-CELL AND NK-CELL NEOPLASMS BASED ON THE 4TH EDITION OF THE WORLD HEALTH ORGANIZATION CLASSIFICATION

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