ArticleLeukemia2026
Advances in the treatment and prognosis of aggressive NK-cell leukemia: results from the ANKL22 study.
Article in Leukemia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
Aggressive NK-cell leukemia (ANKL) is a rare NK-cell leukemia characterized by, an aggressive clinical course, and frequent Epstein-Barr virus association. We retrospectively collected 126 ANKL patients diagnosed between 2000 and 2021 from 71 institutes; 108 were evaluable for analysis to characterize the recent advances. The median age was 49 years (range: 17-90), and 63 patients were male. The median percentage of leukemic cells in the bone marrow and peripheral blood was 19.7% and 10.0%, respectively. The first-line regimens included SMILE (n = 38, 42%), CHOP(-like) (n = 26, 29%), DeVIC (n = 15, 17%), and other L-asparaginase-containing regimens (n = 8, 9%), with the overall response rates of 66%, 31%, 33%, and 50%, respectively. Median overall survival (OS) was 5.5 months, with a 2-year OS of 18.7%. Patients treated with SMILE had significantly better OS than others (2-year OS 30.1% vs. 7.0%; P < 0.001). Prognosis further improved with allogeneic hematopoietic stem cell transplantation (HSCT) (2-year OS 37.2% vs 3.5%; P < 0.001). Multivariate analysis confirmed treatment with SMILE [hazard ratio (HR) 0.53, 95% confidential interval (CI) 0.31-0.88] and allogeneic HSCT (HR 0.33, 95% CI 0.18-0.61) as independent favorable factors. In conclusion, SMILE chemotherapy followed by allogeneic HSCT may improve outcomes in ANKL.
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