High post-treatment serum levels of soluble programmed cell death ligand 1 predict early relapse and poor prognosis in extranodal NK/T cell lymphoma patients
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Hua Wang1,2,3,*, Liang Wang1,2,3,*, Wen-Jian Liu1,2,3,*, Zhong-Jun Xia1,2,3, Hui-Qiang Huang4, Wen-Qi Jiang4, Zhi-Ming Li4, Yue Lu1,2,3
1Department of Hematological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
2State Key Laboratory of Oncology in South China, Guangzhou, 510060, China
3Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
4Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
*These authors have contributed equally to this work
Yue Lu, email: [email protected]
Keywords: extranodal NK/T cell lymphoma, prognosis, soluble programmed cell death ligand 1, asparaginase, minimal residual disease
Received: January 09, 2016 Accepted: March 31, 2016 Published: April 20, 2016
The impact of serum levels of soluble programmed cell death ligand 1 (sPD-L1) on prognosis in patients with Epstein-Barr virus-associated malignancies has never been investigated. We prospectively measured pre- and post-treatment serum sPD-L1 levels and evaluated their prognostic value in 97 patients with newly diagnosed, early stage extranodal NK/T-cell lymphoma (ENKTCL) treated with asparaginase-based chemotherapy followed by radiotherapy. For predicting survival outcomes, serum sPD-L1 levels of 3.23 ng/mL and 1.12 ng/mL were respectively identified for pre- and post-treatment cut-off levels. Patients with high pretreatment (>3.23 ng/mL) had shorter progression-free survival (PFS) and overall survival (OS). In a multivariate survival analysis, post-treatment sPD-L1 >1.12 ng/mL, treatment response (complete vs. non-complete response), and stage II disease were independent prognostic factors for shorter PFS and OS. In patients with a complete response, post-treatment sPD-L1 >1.12 ng/mL was associated with shorter PFS and OS. In patients with high pretreatment sPD-L1 levels (>3.23 ng/mL), low post-treatment sPD-L1 level (≤1.12 ng/mL) correlated with longer PFS and OS. Our data suggest the post-treatment sPD-L1 level is a potent biomarker for predicting early relapse and poor prognosis in early stage ENKTCL patients treated with asparaginase, and may be a useful marker of minimal residual disease.
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