Extranodal natural killer/T-cell lymphoma: An overview on pathology and clinical management

被引:13
作者
Tse, Eric [1 ,5 ]
Fox, Christopher P. [2 ]
Glover, Alexander [3 ]
Yoon, Sang Eun [4 ]
Kim, Won Seog [4 ]
Kwong, Yok-Lam [1 ]
机构
[1] Univ Hong Kong, Sch Clin Med, Dept Med, Hong Kong, Peoples R China
[2] Univ Nottingham, Sch Med, Nottingham, England
[3] Univ Birmingham, Inst Immunol & Immunotherapy, Birmingham, England
[4] Sungkyunkwan Univ, Samsung Med Ctr, Dept Med, Div Hematol Oncol,Sch Med, Seoul, South Korea
[5] Univ Hong Kong, Queen Mary Hosp, Sch Clin Med, Div Haematol,Dept Med, Hong Kong, Peoples R China
关键词
NK; T-cell lymphoma; Epstein Barr virus; Radiotherapy; Chemotherapy; Immunotherapy; INVOLVED-FIELD RADIATION; TUMOR-SUPPRESSOR GENE; DIAGNOSED STAGE IV; NASAL-TYPE; L-ASPARAGINASE; PHASE-II; CONCURRENT CHEMORADIOTHERAPY; (NK)/T-CELL LYMPHOMA; SMILE CHEMOTHERAPY; PD1; BLOCKADE;
D O I
10.1053/j.seminhematol.2022.10.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Natural killer (NK)/T-cell lymphomas arise mainly from NK-cells and occasionally T-cells, and are univer-sally infected with Epstein Barr virus (EBV). They are uncommon lymphomas more prevalent in Asian and Central/South American populations. NK/T-cell lymphomas are clinically aggressive and predomi-nantly extranodal. The most commonly involved sites are the nasal cavity, followed by non-nasal sites including the skin, gastrointestinal tract and testis. The diagnosis of extranodal NK/T-cell lymphoma is established with histological and immunohistochemical examination, together with the demonstration of EBV in the tumour cells. Staging by positron emission tomography computed tomography is essential to inform the optimal management. Plasma EBV DNA quantification should be performed as it serves as a marker for prognostication and treatment response. Survival outcomes of patients with early-stage disease are good following treatment with nonanthracycline based chemotherapy, together with sequen-tial/concurrent radiotherapy. For advanced-stage disease, asparaginase-containing regimens are mostly used and allogeneic haematopoietic stem cell transplantation should be considered for those at high risk of relapse. Salvage chemotherapy is largely ineffective for relapsed/refractory disease, which has a grave prognosis. Novel therapeutic approaches including immune check-point blockade, EBV-specific cytotoxic T-cells, and monoclonal antibodies are being investigated to improve outcomes for those with high risk and relapsed/refractory disease. (c) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:198 / 209
页数:12
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