[Clinical Characteristics and Survival Analysis of 34 Patients with Aggressive NK-Cell Leukemia]

To explore the clinical characteristics and prognosis risk factors of aggressive NK-cell leukemia (ANKL).

The clinical and laboratory data of 34 patients with ANKL and 15 patients with chronic lymphoproliferative disorders of NK cells (CLPD-NK) admitted to the First Affiliated Hospital of Zhengzhou University from September 2019 to December 2024 were retrospectively analyzed. The Kaplan-Meier method was used to calculate survival rates, and the Cox proportional hazards regression model was used to analyze prognostic factors.

Compared with CLPD-NK patients, ANKL patients had a younger median age of onset, a higher proportion patients with EBV-DNA≥500 copies/ml, hepatosplenomegaly and hemophagocytic syndrome. They also presented with a higher peak of fever, a shorter median survival time, lower WBC count, PLT count, ALB and Fib values, while having higher LDH, AST, TG, ferritin, CRP and PCT levels. There were statistically significant differences in the morphology and expression of HLA-DR, CD56, CD57, CD16 and CD158 on abnormall cells between ANKL patients and CLPD-NK patients. Multivariate survival analysis revealed that combined with asparaginase treatment could improve patients' survival, and CRP≥15 mg/L and Fib < 2.0 g/L were independent risk factors affecting the overall survival of patients with ANKL.

The differences in clinical features and laboratory tests between patients with ANKL and CLPD-NK aid in the diagnosis of ANKL. CRP and Fib levels can be used to predict the prognosis of patients, and combined asparaginase therapy can enhance the overall survival of patients.