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Decreased apolipoprotein A-I level indicates poor prognosis in extranodal natural killer/T-cell lymphoma, nasal type

Authors Quan Q, Chen Q, Chen P, Jiang L, Li T, Qiu H, Zhang B

Received 17 September 2015

Accepted for publication 24 November 2015

Published 14 March 2016 Volume 2016:9 Pages 1281—1290

DOI https://doi.org/10.2147/OTT.S96549

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Dr William Cho


Qi Quan,1,2,* Qi Chen,1,2,* Ping Chen,1,2 Li Jiang,1,2 Tingwei Li,1,2 Huijuan Qiu,1,2 Bei Zhang1–3

1State Key Laboratory of Oncology in South China, 2VIP Region, Sun Yat-Sen University Cancer Center, 3Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China

*These authors contributed equally to this work

Background: Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) is an invasive lymphoid malignancy with unfavorable survival, for which a prognostic model has not yet been validated. We hypothesized that serum apolipoprotein A-I (ApoA-I) may serve as a novel prognostic marker for ENKTL.
Patients and methods: A total of 236 newly diagnosed cases of ENKTL were analyzed retrospectively.
Results: The optimal cutoff value for the serum ApoA-I level was determined to be 0.95 g/L. A total of 154 and 82 cases were assigned to the high and low ApoA-I groups, respectively. Patients in the low ApoA-I group tended to present with poorer clinical features, a lower complete remission rate (P=0.001), and poor median progression-free survival (P<0.001) and overall survival (P<0.001). Multivariate analysis using Cox model showed that the serum ApoA-I level was an independent prognostic marker of overall survival (P<0.001) and progression-free survival (P<0.001) for ENKTL patients. For cases in the low-risk group, as assessed by International Prognostic Index, Prognosis Index for peripheral T-cell lymphoma, unspecified, and Korean Prognostic Index, the serum ApoA-I level was able to differentiate cases with poor outcomes from cases with good outcomes.
Conclusion: Our results showed that the baseline serum ApoA-I level was helpful for predicting ENKTL prognosis.

Keywords: apolipoprotein A-I, extranodal NK/T-cell lymphoma, prognosis

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