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Article Open Access

Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma

  • Authors:
    • Pengye Li
    • Geraldine Esther Awakossa
    • Lu Zhou
    • Qiuhui Li
    • Xinxiu Liu
    • Fang Zhu
    • Tao Liu
    • Liling Zhang
  • View Affiliations / Copyright

    Affiliations: Hubei Key Laboratory of Precision Radiation Oncology, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 29
    |
    Published online on: November 11, 2025
       https://doi.org/10.3892/ol.2025.15382
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Abstract

Natural killer/T‑cell lymphoma (NKTCL) is the most common T‑cell non‑Hodgkin lymphoma in China; however, the clinical characteristics and optimal treatment remain unclear. The present study aimed to retrospectively assess the clinical features of patients with NKTCL and to determine treatment strategies. A total of 200 patients who were diagnosed with NKTCL and admitted to the Cancer Center, Union Hospital (Wuhan, China) between June 2013 and June 2022 were identified. Clinical data from these patients were collected and analyzed to evaluate the clinical features, treatment outcomes and prognostic factors. A total of 171 patients diagnosed with NKTCL were ultimately enrolled. Patients were diagnosed at a median age of 45 years and had a male‑to‑female ratio of 2:1. Out of the 171 patients, 117 were in the early stage (stage I/II; 68.4%) and 54 were in the advanced stage (stage III/IV; 31.6%) of NKTCL. Among these patients, B symptoms were present in 60.2% of patients (103/171) and the Eastern Cooperative Oncology Group performance status was scored as 0‑1 in 93.6% of patients (160/171). Most patients had a low‑to‑moderate risk of international prognostic index (147/171; 86.0%), prognostic index for NKTCL (PINK; 122/171; 71.3%) and PINK with extended features (112/171; 65.5%). At baseline, it was demonstrated that Epstein‑Barr virus DNA was positive in the serum of 166/171 patients (2.9%). Combined chemotherapy and radiotherapy at 54 Gy revealed a promising effect with the highest overall response rate (ORR) of 98.2%, a 4‑year progression‑free survival (PFS) rate of 82.5% [95% confidence interval (CI), 75.1‑89.9%] and an overall survival (OS) rate of 92.2% (95% CI, 86.9‑97.5%) for the early‑stage group. Pegasparase‑based chemotherapy was used to treat advanced‑stage patients, resulting in a 4‑year PFS rate of 62.3% (95% CI, 47.4‑77.2%) and an OS rate of 63.5% (95% CI, 48.2‑78.8%). The regimen containing the programmed cell death protein 1 inhibitor camrelizumab demonstrated an ORR of 100% in both the early‑ and advanced‑stage cohorts. Moreover, stage and an age of >60 years were independent prognostic factors for poor PFS, whilst stage and elevated lactate dehydrogenase were independent prognostic factors for poor OS. In conclusion, the results indicated promising efficacy for pegaspargase‑based chemotherapy in terms of response rates and survival outcomes for both early‑ and advanced‑stage patients. However, further refinement of treatment strategies is needed.
View Figures

Figure 1

Kaplan-Meier survival curves of (A)
PFS and (B) OS stratified by disease stage at diagnosis. Patients
with early-stage disease (stage I–II) demonstrated significantly
longer PFS and OS times compared with those with advanced-stage
disease (stage III–IV), highlighting the prognostic impact of tumor
stage in natural killer/T-cell lymphoma. HR, hazard ratio; PFS,
progression-free survival; OS, overall survival; cum, cumulative;
CI, confidence interval.

Figure 2

Kaplan-Meier survival curves of (A)
PFS and (B) OS stratified by chemotherapy regimens, including PIDE,
P-GDP, P-Gemox and PPME. P-GDP, pegaspargase, gemcitabine,
dexamethasone, and cisplatin; PIDE, pegaspargase, ifosfamide,
dexamethasone, and etoposide; P-Gemox, pegaspargase, gemcitabine,
and oxaliplatin; PPME: pegaspargase, etoposide, high-dose
methotrexate, and camrelizumab; PFS, progression-free survival; OS,
overall survival; cum, cumulative.

Figure 3

Kaplan-Meier survival curves of (A)
PFS and (B) OS in the advanced-stage group, stratified by treatment
with chemotherapy alone vs. combined chemoradiotherapy. CT,
chemotherapy; RT, radiotherapy; HR, hazard ratio; PFS,
progression-free survival; OS, overall survival.

Figure 4

Multivariate Cox regression analysis
of prognostic factors associated with PFS and OS. (A) PFS according
to age. (B) OS stratified by LDH levels. (C) OS analysis according
to EBV DNA levels. LDH, lactate dehydrogenase; EBV, Epstein-Barr
virus; HR, hazard ratio; PFS, progression-free survival; OS,
overall survival.
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Copy and paste a formatted citation
Spandidos Publications style
Li P, Awakossa GE, Zhou L, Li Q, Liu X, Zhu F, Liu T and Zhang L: Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma. Oncol Lett 31: 29, 2026.
APA
Li, P., Awakossa, G.E., Zhou, L., Li, Q., Liu, X., Zhu, F. ... Zhang, L. (2026). Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma. Oncology Letters, 31, 29. https://doi.org/10.3892/ol.2025.15382
MLA
Li, P., Awakossa, G. E., Zhou, L., Li, Q., Liu, X., Zhu, F., Liu, T., Zhang, L."Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma". Oncology Letters 31.1 (2026): 29.
Chicago
Li, P., Awakossa, G. E., Zhou, L., Li, Q., Liu, X., Zhu, F., Liu, T., Zhang, L."Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma". Oncology Letters 31, no. 1 (2026): 29. https://doi.org/10.3892/ol.2025.15382
Copy and paste a formatted citation
x
Spandidos Publications style
Li P, Awakossa GE, Zhou L, Li Q, Liu X, Zhu F, Liu T and Zhang L: Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma. Oncol Lett 31: 29, 2026.
APA
Li, P., Awakossa, G.E., Zhou, L., Li, Q., Liu, X., Zhu, F. ... Zhang, L. (2026). Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma. Oncology Letters, 31, 29. https://doi.org/10.3892/ol.2025.15382
MLA
Li, P., Awakossa, G. E., Zhou, L., Li, Q., Liu, X., Zhu, F., Liu, T., Zhang, L."Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma". Oncology Letters 31.1 (2026): 29.
Chicago
Li, P., Awakossa, G. E., Zhou, L., Li, Q., Liu, X., Zhu, F., Liu, T., Zhang, L."Retrospective analysis of clinical characteristics, treatment outcomes and prognosis of patients with natural killer/T‑cell lymphoma". Oncology Letters 31, no. 1 (2026): 29. https://doi.org/10.3892/ol.2025.15382
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