NCCN-IPI对外周T细胞淋巴瘤患者化疗后的预后评估价值

OBJECTIVE: To validate the prognostic value of NCCN-International Prognostic Index (NCCN-IPI) for patients with peripheral T-cell lymphoma (PTCL) treated with CHOP-based chemotherapy. METHODS: A retrospective analysis in 162 PTCL patients who were initially diagnosed and treated in Rui Jin Hospital from January 2003 to May 2013 was conducted. Baseline characteristics were collected, and survival analysis was performed according to the IPI and NCCN-IPI model. RESULTS: The estimated 5-year overall survival (OS) rate and progression free survival (PFS) rate were 33% and 20%, with median OS and PFS of 17.0 months and 9.2 months, respectively. Multivariate analysis indicated ECOG score (PFS: HR=2.418, 95%CI 1.535–3.809, P<0.001; OS: HR=2.347, 95%CI 1.435–3.839, P= 0.001), specific extra-nodal sites (PFS: HR=1.800, 95%CI 1.216–2.665, P=0.003; OS: HR=1.608, 95% CI 1.054–2.454, P=0.027) and pathology type (PFS: HR=0.424, 95% CI 0.184–0.975, P=0.043; OS: HR=0.276, 95% CI 0.087–0.877, P=0.029) were independent prognostic factors of OS and PFS for the patients with PTCL. The survival rates of low risk patients based on NCCI-IPI were remarkably higher than the counterparts based on IPI (5-year OS 74% vs 54%, χ(2)=5.041, P=0.025, 5-year PFS 50% vs 38%, χ(2)= 5.295, P=0.021). NCCN-IPI was outstanding to identify the subgroup of low risk patients with PTCL, who may benefit from conventional chemotherapy such as CHOP or CHOP-like regimen. CONCLUSION: NCCN-IPI is more powerful for low risk PTCL patients and a strong supplement for IPI.