Cancer Research and Treatment

Original Articles

Hematologic malignancy

A New Prognostic Index for Extranodal Natural Killer/T-Cell Lymphoma:Incorporation of Serum β-2 Microglobulin to PINK: Sora Kang, Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Eun Hee Kang, Jung Sun Park, Yoon Sei Lee, Chan-Sik Park, Heounjeong Go, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Seok Jin Kim, Won Seog Kim, Sang Eun Yoon, Young Hyeh Ko, Cheolwon Suh; Cancer Res Treat. 2023;55(1):314-324. Published online March 31, 2022; DOI: https://doi.org/10.4143/crt.2022.015

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Purpose
Prognostic Index for Natural Killer Lymphoma (PINK) is the most widely accepted prognostic model for patients withextranodal natural killer/T-cell lymphoma (ENKTL) treated with non-anthracycline–based therapy. We aimed to evaluate the prognostic implications of serum β-2 microglobulin (β2M) in the context of PINK and proposed a new prognostic model.
Materials and Methods
A total of 138 patients who were newly diagnosed with ENKTL and treated with non-anthracycline-based chemotherapy were identified. The cut-off value of high serum β2M was calculated by maximal-chi square methods (4.1 mg/L). A new prognostic model incorporating serum β2M into PINK was proposed and validated in an independent validation cohort (n=88).
Results
The patients’ median age was 53.5 years (range, 19 to 80 years). Patients with high serum β2M levels had significantly worse overall survival (OS) and progression-free survival (PFS). In multivariate analysis, high serum β2M was an independent adverse prognostic factor for OS. A new PINK-B (Prognostic Index for Natural Killer Lymphoma-serum β-2 microglobulin) model stratifiedpatients into three groups with distinct OS and PFS in the training cohort (3-year OS, 84.1% [95% confidence interval, 75.1 to 94.2], 46.8% [36.1 to 60.8] and 17.6% [6.3 to 49.2] for the low-, intermediate, and high-risk groups, respectively; 3-year PFS, 70.6% [59.4 to 83.8], 35.9% [25.9 to 49.8], and 7.35% [1.1 to 46.7] for the low-, intermediate-, and high-risk groups, respectively). The PINK-B model was further validated in an independent cohort.
Conclusion
Serum β2M is an independent prognostic factor for ENKTL patients. The new serum β2M-based prognostic model may be useful for identifying ultra-high-risk patients, and it can easily be adopted into daily clinical practice.

Citations

Citations to this article as recorded by

Elevated serum IL-6 and total IgEAb are associated with poor survival in natural killer/T-cell lymphoma
Yun Hui, Yingjun Gao, Jiawei Li, Qingtao Kong, Yuanyuan Duan, Haibo Liu, Fang Liu, Hong Sang
Annals of Hematology.2024; 103(4): 1285. CrossRef
Prognostic Impact of Serum β2-Microglobulin Levels in Hodgkin Lymphoma Treated with ABVD or Equivalent Regimens: A Comprehensive Analysis of 915 Patients
Theodoros P. Vassilakopoulos, Maria Arapaki, Panagiotis T. Diamantopoulos, Athanasios Liaskas, Fotios Panitsas, Marina P. Siakantaris, Maria Dimou, Styliani I. Kokoris, Sotirios Sachanas, Marina Belia, Chrysovalantou Chatzidimitriou, Elianna A. Konstantin
Cancers.2024; 16(2): 238. CrossRef
Prognostic Value of18F-FDG PET/CT Radiomics in Extranodal Nasal-Type NK/T Cell Lymphoma
Yu Luo, Zhun Huang, Zihan Gao, Bingbing Wang, Yanwei Zhang, Yan Bai, Qingxia Wu, Meiyun Wang
Korean Journal of Radiology.2024; 25(2): 189. CrossRef
A novel prognostic index for extranodal natural killer/T-cell lymphoma in the era of pegaspargase/L-asparaginase
Ziyuan Shen, Xudong Zhang, Yujie Li, Xicheng Chen, Xing Xing, Hao Zhang, Jingjing Ye, Ling Wang, Tao Jia, Taigang Zhu, Yuqing Miao, Chunling Wang, Hui Liu, Liang Wang, Wei Sang
Future Oncology.2024; 20(28): 2071. CrossRef

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Hematologic Malignancy

Prognostic Stratification of Patients with Burkitt Lymphoma Using Serum β2-microglobulin Levels: Hyung-Don Kim, Hyungwoo Cho, Shin Kim, Kyoungmin Lee, Eun Hee Kang, Jung Sun Park, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Dok-Hyun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2021;53(3):847-856. Published online December 17, 2020; DOI: https://doi.org/10.4143/crt.2020.1060

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Purpose
We aimed to investigate the prognostic value of serum β2-microglobulin for patients with Burkitt lymphoma (BL) and to propose a risk-stratifying classification system.
Materials and Methods
A prospective registry-based cohort study of BL patients treated with dose-intensive or effective dose-adjusted chemotherapies (n=81) was conducted. Survival outcomes were compared based on previously reported risk groups and/or serum β2-microglobulin levels. A risk-stratifying classification system incorporating serum β2-microglobulin levels was proposed and validated in an independent validation cohort (n=60).
Results
The median age was 47 years, and 57 patients (70.4%) were male. Patients with high serum β2-microglobulin levels (> 2 mg/L) had significantly worse progression-free survival (PFS) and overall survival (OS) (p < 0.01 for both). Serum β2-microglobulin levels further stratified patients in the low-risk and high-risk groups in terms of PFS (p=0.010 and p=0.044, respectively) and OS (p=0.014 and p=0.026, respectively). Multivariate analyses revealed that a high serum β2-microglobulin level (> 2 mg/L) was independently associated with a shorter PFS (hazards ratio [HR], 3.56; p=0.047) and OS (HR, 4.66; p=0.043). The new classification system incorporating the serum β2-microglobulin level allowed the stratification of patients into three distinct risk subgroups with 5-year OS rates of 100%, 89.5%, and 62.5%. In an independent cohort of BL, the system was validated by stratifying patients with different survival outcomes.
Conclusion
Serum β2-microglobulin level is an independent prognostic factor for BL patients. The proposed β2-microglobulin–based classification system could stratify patients with distinct survival outcomes, which may help define appropriate treatment approaches for individual patients.

Citations

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Prognostic Factors for Survival in Adults With Burkitt Lymphoma: A Systematic Review
Aythami de Armas‐Castellano, Diego Infante‐Ventura, Tasmania del Pino‐Sedeño, Yadira González Hernández, Raul Quiros, Beatriz León‐Salas, Vincent Ribrag, María M. Trujillo‐Martín
Cancer Medicine.2025;[Epub] CrossRef
The clinical significance and prognostic value of serum beta-2 microglobulin in adult lymphoma-associated hemophagocytic lymphohistiocytosis: a multicenter analysis of 326 patients
Ze Jin, Yi Miao, Jie Zhang, Jing Zhang, Chunling Wang, Xuzhang Lu, Yuqing Miao, Miao Sun, Yunping Zhang, Yun Zhuang, Haiwen Ni, Jingyan Xu, Wanchuan Zhuang, Min Zhao, Jianfeng Zhu, Min Xu, Guoqiang Lin, Haiying Hua, Xiaoyan Xie, Maozhong Xu, Tao Jia, Liji
Annals of Hematology.2024; 103(7): 2257. CrossRef
Prognostic Value of18F-FDG PET/CT Radiomics in Extranodal Nasal-Type NK/T Cell Lymphoma
Yu Luo, Zhun Huang, Zihan Gao, Bingbing Wang, Yanwei Zhang, Yan Bai, Qingxia Wu, Meiyun Wang
Korean Journal of Radiology.2024; 25(2): 189. CrossRef
The Role of Beta2-Microglobulin in Central Nervous System Disease
Zhen-Yuan Liu, Feng Tang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
Cellular and Molecular Neurobiology.2024;[Epub] CrossRef
Serum beta2-microglobulin acts as a biomarker for severity and prognosis in glioma patients: a preliminary clinical study
Zhen-Yuan Liu, Feng Tang, Jing Wang, Jin-Zhou Yang, Xi Chen, Ze-Fen Wang, Zhi-Qiang Li
BMC Cancer.2024;[Epub] CrossRef
Serum beta2-microglobulin and peripheral blood eosinophils for the assessment of severity and prognosis with omicron variant COVID-19 infection
Jie Tan, Hanxi Fang, Xiao Hu, Ming Yue, Junling Yang
Frontiers in Molecular Biosciences.2024;[Epub] CrossRef
A novel inflammation-related prognostic model for predicting the overall survival of primary central nervous system lymphoma: A real-world data analysis
Zhentian Wu, Chenyi Wang, Yao Lyu, Zheshen Lin, Ming Lu, Shixiong Wang, Bingxuan Wang, Na Yang, Yeye Li, Jianhong Wang, Xiaohui Duan, Na Zhang, Jing Gao, Yuan Zhang, Miaowang Hao, Zhe Wang, Guangxun Gao, Rong Liang
Frontiers in Oncology.2023;[Epub] CrossRef
Beta2-microglobulin is a valuable marker and identifies a poor-prognosis subgroup among intermediate-risk patients with diffuse large B cell lymphoma
Ning-Chun Chen, Hung Chang, Hsiao-Wen Kao, Che-Wei Ou, Ming-Chung Kuo, Po-Nan Wang, Tung-Liang Lin, Jin-Hou Wu, Yu-Shin Hung, Yi-Jiun Su, Yuen-Chin Ong, Hsuan-Jen Shih
Clinical and Experimental Medicine.2023; 23(7): 3759. CrossRef
Tuberculosis combined with Burkitt lymphoma in a kidney transplant recipient: A case report and literature review
Jian-Nan Hu, Mu-Qing Yu, Li-Juan Hua, Chen Bao, Qian Liu, Chao Liu, Zi-Ling Li, Xi Wang, Shu-Yun Xu
Medicine.2023; 102(18): e33671. CrossRef
Elevated serum beta-2 microglobulin level predicts short-term poor prognosis of patients with de novo acute omicron variant COVID-19 infection
Shengping Gong, Ruishuang Ma, Ting Zhu, Xiaoqin Ge, Rongrong Xie, Qingsong Tao, Cong Shi
Frontiers in Cellular and Infection Microbiology.2023;[Epub] CrossRef
An Externally Validated Nomogram for Predicting the Overall Survival of Patients With Diffuse Large B-Cell Lymphoma Based on Clinical Characteristics and Systemic Inflammatory Markers
Yajiao Liu, Li Sheng, Haiying Hua, Jingfen Zhou, Ying Zhao, Bei Wang
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Prognostic significance of serum β2-microglobulin levels in patients with peripheral T-cell lymphoma not otherwise specified
Hyung-Don Kim, Hyungwoo Cho, Byeong Seok Sohn, Chan-Sik Park, Jooryung Huh, Jin Sook Ryu, Sang-Wook Lee, Sang Eun Yoon, Seok Jin Kim, Young Hyeh Ko, Won Seog Kim, Cheolwon Suh
Leukemia & Lymphoma.2022; 63(1): 124. CrossRef

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Lymphoma

Prognostic Impact of Age at the Time of Diagnosis in Korean Patients with Diffuse Large B-cell Lymphoma in the Rituximab Era: A Single Institution Study: Hee Sang Hwang, Meejeong Kim, Chan-Sik Park, Dok Hyun Yoon, Cheolwon Suh, Jooryung Huh, Heounjeong Go; Cancer Res Treat. 2021;53(1):270-278. Published online September 15, 2020; DOI: https://doi.org/10.4143/crt.2020.626

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Purpose
In contrast to the Western diffuse large B-cell lymphoma (DLBCL), prognostic impact of age in a Korean population with DLBCL has not been fully evaluated.
Materials and Methods
Six hundred and eight DLBCL patients treated with rituximab-containing chemotherapeutic regimens from January 2002 to March 2012 in Asan Medical Center were enrolled. Survival models using the restricted cubic spine−transformed age variable were constructed to evaluate non-linear relationships between age and survival outcome. Finally, age was categorized according to the conventional international prognostic index (IPI), National Comprehensive Cancer Network (NCCN)-IPI, and Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GELTAMO)-IPI schemes and the prognostic implications were evaluated.
Results
The relative hazard did not change significantly during the first to fifth decades, but began to increase exponentially in patients aged over 62 years. This pattern or relationship was also retained in a multivariate model fitted to the age-adjusted IPI and relative dose intensity. Multivariate survival analysis revealed that age > 75 years, but not age > 60 years, was associated independently with poor overall and progression-free survival when the relative dose intensity and age-adjusted IPI were taken into account.
Conclusion
The outcome of DLBCL in Korean populations may deteriorate rapidly as age exceeds 62 years. Therefore, a consensus cutoff value for age in Korean DLBCL patients should be determined to better predict prognosis.

Citations

Citations to this article as recorded by

Two distinct age-prognosis patterns in patients with esophageal cancer undergoing surgical and radiotherapy treatments: a combined analysis of 3JECROG and SEER databases
Chen Li, Xiao Chang, Qifeng Wang, Qingsong Pang, Zefen Xiao, Wencheng Zhang, Zhiyong Yuan
Therapeutic Advances in Medical Oncology.2024;[Epub] CrossRef
SOHO State of the Art Updates and Next Questions | Diffuse Large B-Cell Lymphoma in Older Adults: A Comprehensive Review
Varun Iyengar, Paul Hamlin, Pallawi Torka
Clinical Lymphoma Myeloma and Leukemia.2024;[Epub] CrossRef
Impact of R-CHOP dose intensity on survival outcomes in diffuse large B-cell lymphoma: a systematic review
Edward J. Bataillard, Chan Yoon Cheah, Matthew J. Maurer, Arushi Khurana, Toby A. Eyre, Tarec Christoffer El-Galaly
Blood Advances.2021; 5(9): 2426. CrossRef

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Case Report

Diffuse Large B-Cell Lymphoma with Involvement of the Breast and Testis in a Male Patient: Eunji Choi, Jae-Cheol Jo, Dok Hyun Yoon, Shin Kim, Kyoungmin Lee, Jooryung Huh, Chan-Sik Park, Sang Wook Lee, Cheolwon Suh; Cancer Res Treat. 2015;47(3):539-543. Published online September 11, 2014; DOI: https://doi.org/10.4143/crt.2013.245

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Here we report a case of a 76-year-old man with diffuse large B-cell lymphoma (DLBCL) with simultaneous involvement of the right breast and left testicle. The patient underwent complete resection of the involved testis, followed by immunochemotherapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) and prophylactic radiotherapy to the contralateral testis. Following this multimodal therapy, he achieved a complete response. This is a rare case of DLBCL involving both the breast and the testis in a male patient.

Citations

Citations to this article as recorded by

Rare incidence of diffuse large B-cell lymphoma (DLBCL) with bilateral breast and testicular involvement in a male patient: A case report and review of the literature
Sarah Ayad, Anuraag Sah, Kirolos Gergis, Michelle Cholankeril
Current Problems in Cancer: Case Reports.2022; 5: 100142. CrossRef
Primary breast lymphoma in males: Incidence, demographics, prognostic factors, survival, and comparisons with females
Jie Zhang, Binbin Ma, Hong Ji, Rong Guo
Frontiers in Surgery.2022;[Epub] CrossRef
Diffuse Large B-Cell Breast Lymphoma: A Case Series
Afaf H Al Battah, Einas A Al Kuwari, Zsolt Hascsi, Abdulqadir J Nashwan, Halima Elomari, Hisham Elsabah, Safa Al Azawi, Samah Kohla, Dina Soliman, Mohamed A Yassin
Clinical Medicine Insights: Blood Disorders.2017; 10: 1179545X1772503. CrossRef

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