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<p>Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive malignancy with poor outcomes in advanced-stage disease. Although progression of disease within 24 months (POD24) serves as a powerful predictor of poor survival in various lymphoma subtypes, its utility in advanced-stage ENKTL has not been specifically validated. This study aims to identify high-risk patients with advanced-stage ENKTL and determine the clinical factors associated with early recurrence following anti-tumor treatment. We retrospectively analyzed 119 patients with advanced-stage ENKTL. All patients received asparaginase-based chemotherapy. Of the 119 patients, 81 patients (68.1%) experienced POD24. The 5-year overall survival (OS) rate was 36.0% for the entire cohort. Patients with POD24 had significantly worse outcomes compared to non-POD24 patients (5-year OS: 10.6% vs. 81.4%; p &lt; 0.001). The optimal thresholds for serum albumin (ALB) and lactate dehydrogenase (LDH) levels were identified as 35.5&#xa0;g/Land 264 u/L, respectively, and 6.0 for lactate dehydrogenase/albumin ratio (LAR). The result identified Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, LDH &gt;264 u/L, ALB &lt;35.5 g/L, LAR &gt;6.0, lymphocyte count &lt;1.0×10⁹/L, and platelet count &lt;75×10⁹/L as significant risk factors for POD24. In the subgroup with available Epstein-Barr virus (EBV)-DNA data (n=85), LAR &gt;6.0 remained significantly associated with POD24. POD24 occurs in approximately two-thirds of advanced-stage ENKTL patients and serves as a critical marker for poor prognosis. Baseline LAR &gt;6.0 is a readily available biomarker for predicting POD24, independent of EBV-DNA status. These findings facilitate early risk stratification and may guide treatment intensification strategies in this population.</p>

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Lactate dehydrogenase/albumin ratio predicts progression of disease within 24 months (POD24) in advanced-stage extranodal natural killer/T cell lymphoma

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月19日

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  • Na Li,
  • Xi Chen,
  • Leiming Sheng,
  • You Feng,
  • Shihui Min,
  • Jing Huang,
  • Rong Luo,
  • Liqun Zou

摘要

Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive malignancy with poor outcomes in advanced-stage disease. Although progression of disease within 24 months (POD24) serves as a powerful predictor of poor survival in various lymphoma subtypes, its utility in advanced-stage ENKTL has not been specifically validated. This study aims to identify high-risk patients with advanced-stage ENKTL and determine the clinical factors associated with early recurrence following anti-tumor treatment. We retrospectively analyzed 119 patients with advanced-stage ENKTL. All patients received asparaginase-based chemotherapy. Of the 119 patients, 81 patients (68.1%) experienced POD24. The 5-year overall survival (OS) rate was 36.0% for the entire cohort. Patients with POD24 had significantly worse outcomes compared to non-POD24 patients (5-year OS: 10.6% vs. 81.4%; p < 0.001). The optimal thresholds for serum albumin (ALB) and lactate dehydrogenase (LDH) levels were identified as 35.5 g/Land 264 u/L, respectively, and 6.0 for lactate dehydrogenase/albumin ratio (LAR). The result identified Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, LDH >264 u/L, ALB <35.5 g/L, LAR >6.0, lymphocyte count <1.0×10⁹/L, and platelet count <75×10⁹/L as significant risk factors for POD24. In the subgroup with available Epstein-Barr virus (EBV)-DNA data (n=85), LAR >6.0 remained significantly associated with POD24. POD24 occurs in approximately two-thirds of advanced-stage ENKTL patients and serves as a critical marker for poor prognosis. Baseline LAR >6.0 is a readily available biomarker for predicting POD24, independent of EBV-DNA status. These findings facilitate early risk stratification and may guide treatment intensification strategies in this population.