This study is about extranodal NK/T-cell lymphoma, a rare subtype of Epstein-Barr virus related to non-Hodgkin lymphoma. It has distinct geographic and ethnic predilection, being more frequent in some Latin American countries such as Mexico, Guatemala and Peru. Our study showed clinical features, therapeutic approaches and outcomes of NK/T-cell lymphoma in some Latin American countries in order to fill the knowledge gaps regarding extranodal NK/T-cell lymphoma in this region.
What was the design of the study?
It’s a retrospective, multinational analysis, including newly diagnosed NK/T-cell lymphoma from Guatemala, Mexico, Brazil, Peru and Bolivia, from 2000 to 2023. We collected baseline demographics, clinical and biological characteristics, treatment patterns, and outcomes. Our primary endpoint was overall survival.
What are the key results?
A total of 303 patients were included with a median age of 44 years, male predominance, with nasal [??] and symptoms were present in 50% of the patients. Early stage was more frequent. 88% of the patients received a first line of treatment, including congruent chemotherapy and radiotherapy in 68%, only chemotherapy in 26% and radiotherapy in 6%. Th systemic chemotherapy-based regimens included anthracyclines in 28%, platinum-based regimens in 13% and asparaginase-based regimens in 36%.
Complete response rates, according to the chemotherapy, were 39% for anthracycline-based regimens, 67% for platinum-based regimens and 49% for asparaginase-based regimens. No differences in results and treatment regimens in patients in early stage, however, the patients with advanced stage have had better results with platinum-based regimens with or without asparaginase versus anthracycline-based regimens.
The median follow-up was reached to 12 months. The overall survival was 59%. There was overall survival seen in patients in advanced stage, indistinctive of the treatment regimen. When we analysed the overall survival between the different types of chemotherapy, we observed that the patients treated with asparaginase regimens had better overall survival – 38 months – and the patients with advanced stage had 6 months of overall survival and the patients with early stage had 28 months in the complete cohort.
The leading causes of death were progression, infection and lack of access to chemotherapy.
What is the clinical significance of these results?
This study represents one of the largest analyses of NK/T-cell lymphoma in Latin America, providing valuable insight into the clinical treatment patterns and outcomes. Our findings highlight the poor prognosis of advanced stage, underscoring the need for early detection and timely intervention. This study also reveals the lack of access to new drugs because only 36% of the patients had access to asparaginase.
Some of the challenges are in both access to early detection and timely intervention, access to clinical trials, access to new drugs and getting trained in lymphoma for haematologists. But there are some research groups in Latin America who help other countries in Latin America, such as the Latin American Group of Lymphoproliferative Disorders here. They are focussing on research and they are collecting their own data. They are looking for [??] gaps in access to the knowledge and the diagnosis in their region. They are doing advocacy to make visible to Latin American cancer centres, to participate in clinical trials about rare lymphomas that have a high incidence in this region.
