ArticleAnnals of hematology2026
Lactate dehydrogenase/albumin ratio predicts progression of disease within 24 months (POD24) in advanced-stage extranodal natural killer/T cell lymphoma.
Article in Annals of hematology, 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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Abstract
Extranodal natural killer/T-cell lymphoma (ENKTL) is an aggressive malignancy with poor outcomes in advanced-stage disease. Although progression of disease within 24 months (POD24) serves as a powerful predictor of poor survival in various lymphoma subtypes, its utility in advanced-stage ENKTL has not been specifically validated. This study aims to identify high-risk patients with advanced-stage ENKTL and determine the clinical factors associated with early recurrence following anti-tumor treatment. We retrospectively analyzed 119 patients with advanced-stage ENKTL. All patients received asparaginase-based chemotherapy. Of the 119 patients, 81 patients (68.1%) experienced POD24. The 5-year overall survival (OS) rate was 36.0% for the entire cohort. Patients with POD24 had significantly worse outcomes compared to non-POD24 patients (5-year OS: 10.6% vs. 81.4%; p < 0.001). The optimal thresholds for serum albumin (ALB) and lactate dehydrogenase (LDH) levels were identified as 35.5 g/Land 264 u/L, respectively, and 6.0 for lactate dehydrogenase/albumin ratio (LAR). The result identified Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, LDH >264 u/L, ALB <35.5 g/L, LAR >6.0, lymphocyte count <1.0×10⁹/L, and platelet count <75×10⁹/L as significant risk factors for POD24. In the subgroup with available Epstein-Barr virus (EBV)-DNA data (n=85), LAR >6.0 remained significantly associated with POD24. POD24 occurs in approximately two-thirds of advanced-stage ENKTL patients and serves as a critical marker for poor prognosis. Baseline LAR >6.0 is a readily available biomarker for predicting POD24, independent of EBV-DNA status. These findings facilitate early risk stratification and may guide treatment intensification strategies in this population.
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