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Clinical Disparity and Favorable Prognoses for Patients With Waldeyer Ring Extranodal Nasal-type NK/T-cell Lymphoma and Diffuse Large B-cell Lymphoma

Wu, Run-Ye MD*; Li, Ye-Xiong MD*; Wang, Wei-Hu MD*; Jin, Jing MD*; Wang, Shu-Lian MD*; Liu, Yue-Ping MD*; Song, Yong-Wen MD*; Fang, Hui MD*; Ren, Hua MD*; Liu, Qing-Feng MD*; Wang, Zhao-Yang MD*; Qi, Shu-Nan MD*; Lu, Ning-Ning MD*; Chen, Bo MD*; Zhang, Xi-Mei MD*; Zhou, Li-Qiang MD; Liu, Xin-Fan MD*; Yu, Zi-Hao MD*

American Journal of Clinical Oncology: February 2014 - Volume 37 - Issue 1 - p 41–46
doi: 10.1097/COC.0b013e318261084b
Original Articles: Hematopoeitic

Objectives: This study aimed to compare the clinical characteristics and prognosis of Waldeyer ring extranodal nasal-type natural killer (NK)/T-cell lymphoma (WR-NKTCL) and Waldeyer ring diffuse large B-cell lymphoma (WR-DLBCL).

Methods: Consecutive diagnoses of 122 WR-DLBCL and 44 WR-NKTCL patients, receiving mainly primary radiotherapy in early-stage WR-NKTCL and primary chemotherapy in early-stage WR-DLBCL, were reviewed.

Results: WR-NKTCL occurred predominately in young males, as nasopharyngeal stage I disease with B-symptoms, extranodal dissemination, and involving adjacent structures. WR-DLBCL was mainly stage II tonsillar disease with regional lymph node involvement. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 74% and 67% in WR-DLBCL, respectively, and 68% (P=0.468) and 59% (P=0.303) in WR-NKTCL. In stages I and II disease, WR-DLBCL 5-year OS and PFS were 79% and 76% compared with 72% (P=0.273) and 62% (P=0.117) in WR-NKTCL. In stage I disease, WR-DLBCL 5-year OS and PFS were 81% and 81%, compared with 76% (P=0.394) and 63% (P=0.236) in WR-NKTCL. In addition, the prognostic factors and failure patterns in WR-DLBCL and WR-NKTCL differed substantially.

Conclusions: These results indicate that remarkable clinical disparities exist between WR-DLBCL and WR-NKTCL; however, different treatment strategies for each can result in similarly favorable prognoses.

Departments of *Radiation Oncology

Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing, P.R. China

Y.X.L. designed the research, analyzed the data, and wrote the paper. R.Y.W. analyzed the data, made the figures, and wrote the paper. W.H.W., J.J., S.L.W., Y.P.L., Y.W.S., H.F., H.R., Q.F.L., Z.Y.W., S.N.Q., N.N.L., B.C., X.M.Z., L.Q.Z., X.F.L., and Z.H.Y. selected the cases and analyzed the clinical data.

Supported by the National Natural Science Foundation of China 30870736 and 81071829.

The authors declare no conflicts of interest.

Reprints: Ye-Xiong Li, MD, Department of Radiation Oncology, Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021, P.R. China. E-mail: yexiong@yahoo.com.

© 2014 by Lippincott Williams & Wilkins, Inc