Ki-67 Can Predict the Response to the Gemcitabine, Oxaliplatin And L-asparaginase Regimen (GELOX) and Prognosis in Patients with Nasal Natural Killer/T-cell Lymphoma

Abstract

GELOX (gemcitabine, oxaliplatin and L-asparaginase) regimen showed an impressive result in our previousstudy, but the effect of this new regimen is still dissatisfying for some patients, so it is necessary to identify whichpatients will benefit from this regimen. A total of fifty-one cases with nasal natural killer/T-cell lymphoma receivinginitial GELOX chemotherapy were enrolled in this study. The ki-67 expression detected by immunohistochemistry(IHC) in the specimens ranged from 10% to 90%, with a median value of 70%, so cases higher than the medianvalue (≥70%) were defined as high ki-67 expression, and the others were designated as low ki-67 expression.The response rate had no statistical difference between low ki-67 expression group and high ki-67 expressiongroup (P=0.291) though the value in the former group was relatively high. After a median follow-up of 18.03months, the 3-year progression-free survival (PFS) for patients with low ki-67 expression was significantly higherthan those with high ki-67 expression (83.8% vs. 47.9%, P=0.038). In the stage I/II subgroup, 3-year PFS andoverall survival (OS) were statistically higher in the patients with low ki-67 expression than those with high ki-67 expression. Multivariate analysis revealed high ki-67 expression was an independent prognostic factor forPFS. These results suggest that low ki-67 expression can predict a good response of GELOX in these patients,and the combination of ki-67 expression and early stage is helpful to identify an excellent prognosis subgroupfrom patients receiving GELOX in this disease.