| Objective : To explore the correlation between NK/T cell lymphoma and EB virus infection,summarize the clinical characteristics of NK/T cell lymphoma,and then explore the clinical characteristics and value of EB virus DNA in the monitoring and prognosis evaluation of the efficacy of the disease.Methods:The clinical data of 40 patients with extrajunction NK/T cell lymphoma admitted to the Department of Hematology,Oncology and Otolaryngology Department of Youjiang Ethnic Medical College and Baise People’s Hospital from January 2012 to December 2022 were retrospectively analyzed.According to gender(male,female),age(≤60years old,>60 years old),whether there are B symptoms,whether there is elevated lactate dehydrogenase,bone marrow involvement,other extranasal organs,whether it is associated with hemophagocyte syndrome,pre-treatment EB virus DNA yin,EB virus DNA positive after treatment 1 course of treatment and EB virus DNA yin after treatment,EB virus DNA yin,curative effect(CR,PR,PD),tumor staging,IPI prognosis risk,etc.,etc.,the clinical characteristics of patients and the value of EB virus DNA in clinical efficacy monitoring and prognosis evaluation are analyzed.Results:The median age of onset for all patients with extranodal NK/T cell lymphoma is46.5(18-69)years old,with a male to female ratio of 4.7:1.The proportion of extranodal NK/T cell lymphoma patients in the EB virus DNA negative group before treatment to those in the EB virus DNA positive group before treatment was 1:3.4,with a median follow-up time of 21(3-120)months.The median overall survival time(OS)of extranodal NK/T cell lymphoma patients in the EB virus DNA negative group before treatment was 60 months,and the 1-year and 3-year OS rates were 33.3% and 66.7%,respectively,The 1-year and 3-year progression free survival(PFS)rates were 33.3% and 66.7%,respectively.The median OS time of extranodal NK/T cell lymphoma patients in the EB virus DNA positive group before treatment was 19 months,with 1-year and 3-year OS rates of 74.2% and 9.7%,respectively.The 1-year and 3-year PFS rates were 67.7% and 6.5%,respectively.There was no statistically significant difference in 1-year OS between the EB virus DNA negative group and the positive group before treatment in patients with extranodal NK/T cell lymphoma(P=0.062).However,there was a statistically significant difference in 3-year OS between the EB virus negative group and the positive group before treatment in patients with extranodal NK/T cell lymphoma(P=0.002),There was no statistically significant difference in 1-year PFS between the EB virus negative group and the positive group before treatment in patients with extranodal NK/T cell lymphoma(P=0.142).There was a statistically significant difference in 3-year PFS between the EB virus negative group and the positive group before treatment in patients with extranodal NK/T cell lymphoma(P<0.001).28 patients(70.0%)had elevated lactate dehydrogenase levels(greater than 250 U/L)during the course of the disease.30 patients(75.0%)had more than 1 extranodal organ involvement,7 patients(17.5%)had bone marrow involvement during the course of the disease,4 patients(10.0%)had central nervous system involvement during the course of the disease,and 3 patients(7.5%)had gastrointestinal involvement.According to the diagnostic criteria for hemophagocytic syndrome in 2004,15 patients(37.5%)with extranodal NK/T-cell lymphoma were diagnosed with hemophagocytic syndrome during the course of the disease.There were 9(22.5%)patients with extranodal NK/T-cell lymphoma in the high-risk group with an IPI score.Before treatment,the proportion of patients in the EB virus DNA positive group with B symptoms was higher than that in the negative group(93.5% vs 33.3%),with a statistically significant difference(P<0.001).Before treatment,the proportion of patients in the EB virus DNA positive group with an increase in lactate dehydrogenase was higher than that in the negative group(80.6% vs 33.3%),with a statistically significant difference(P=0.021),The proportion of patients with positive EB virus DNA before treatment who were involved in other organs during the course of the disease was higher than those with negative EB virus DNA(87.1% vs33.3%),and the difference was statistically significant(P=0.004).There was no statistically significant difference between the EB virus DNA positive group and the EB virus DNA negative group in terms of age ≥ 60 years old(P=0.874),bone marrow involvement(P=0.284),and hemophagocytic syndrome(P=0.143).The first-line treatment achieved CR rates in patients with positive EB virus DNA and those with negative EB virus DNA before treatment were 22.6% and 66.7%,respectively,with statistically significant differences(P=0.030).In terms of prognosis,a univariate analysis was conducted on 40 patients with extranodal NK/T cell lymphoma,and a multivariate analysis was conducted on those with P<0.1 in the univariate analysis.The results showed that age,increased lactate dehydrogenase during the course of the disease,involvement of other organs during the course of the disease,hemophagocytic syndrome during the course of the disease,positive EB virus DNA before treatment,and positive EB virus DNA after one course of treatment were not statistically significant factors affecting the patient’s survival time;During the course of the disease,there was a statistically significant difference in the presence of B symptoms(P=0.001),and after treatment,there was a statistically significant difference in EB virus DNA positivity(P<0.001).The difference in physical fitness score ≥ 2 points was statistically significant(P=0.020),indicating that the three are independent prognostic factors affecting the survival time of patients with extranodal NK/T-cell lymphoma.Conclusion:The EB virus DNA positive group before treatment has a negative impact on the survival outcomes of extranodal NK/T cell lymphoma.The course of disease combined with B symptoms,physical condition score,and high plasma EB virus DNA levels after treatment are independent adverse prognostic factors in multivariate analysis,which can be used for early prediction of efficacy and prognosis. |
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