Open AccessAggressive natural killer cell leukemia: Therapeutic potential of l ‐asparaginase and allogeneic hematopoietic stem cell transplantation
Author(s) -
Ishida Fumihiro,
Ko Young Hyeh,
Kim Won Seog,
Suzumiya Junji,
Isobe Yasushi,
Oshimi Kazuo,
Nakamura Shigeo,
Suzuki Ritsuro
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2012.02251.x
Subject(s) - medicine , hematopoietic stem cell transplantation , chemotherapy , transplantation , bone marrow , leukemia , retrospective cohort study , gastroenterology , oncology
We conducted a retrospective J apan– K orea multicenter study to better elucidate the clinicopathologic features and therapeutic modalities for aggressive natural killer cell leukemia ( ANKL ). A total of 34 patients were analyzed. The median age of the patients was 40 years. Among the patients in the study, four had a history of E pstein– B arr virus‐related disorders. Three types of ANKL cells were categorized according to their morphological features. Leukemic cells were below 20% in both peripheral blood and bone marrow of 11 patients. The clinical characteristics and prognoses of these 11 patients did not differ significantly from those of the others. As an initial therapy, l ‐asparaginase chemotherapy resulted in a better response. A total of six patients received allogeneic hematopoietic stem cell transplantation ( HSCT ) and two received autologous HSCT , with all in non‐complete remission ( CR ). After HSCT , four with allogeneic and one with autologous HSCT reached CR . Median survival of all patients was 51 days. Median survival for the patients with and without HSCT were 266 and 36 days, respectively. A total of two patients with allogeneic HSCT were alive and in CR . All patients without HSCT died of ANKL . The use of l ‐asparaginase was indicated as a factor for longer survival ( HR 0.33, 95% confidence interval; 0.13–0.83, P = 0.02). Early diagnosis of ANKL , l ‐asparaginase‐based chemotherapy and allogeneic HSCT might lead to improved patient outcomes. ( Cancer Sci 2012; 103: 1079–1083)