NK-Cell Lymphomas

  • Dai Chihara
  • Yasuhiro OkiEmail author
Part of the Cancer Treatment and Research book series (CTAR, volume 176)


NK-cell malignancies are rare aggressive diseases associated with poor clinical outcome. There is a significant geographic variation in their incidence. At least a part of the reason for that is the fact that Epstein–Barr virus plays an important role in pathogenesis, and importantly, the plasma viral titer reflects disease burden and response to therapy. Extranodal NK/T-cell lymphoma, nasal type (ENKL), is the most common disease subtype in NK-cell malignancies. Conventional anthracycline-based chemotherapy was historically used for ENKL, only to produce dismal outcome. More recently, concurrent chemoradiation therapy for early-stage disease and non-anthracycline-based L-asparaginase containing chemotherapy have been studied, showing improved clinical response and survival, with long-term survival rates of 60–70% and 50–60%, respectively. Stem cell transplant can provide long-term disease control in recurrent or refractory disease settings, but the role of frontline use of such approach is yet to be determined. Several novel therapeutic approaches have shown promising results, and enrollment to clinical trials is the essential key to improve the treatment outcome in the future.


NK-cell lymphoma Treatment Concurrent chemoradiotherapy L-asparaginase Stem cell transplant Review 


  1. 1.
    Swerdlow S, Campo E, Harris N, Jaffe E, Pileri S, Stein H et al (2008) In: Lyon F (ed) WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edn. International Agency for Research on CancerGoogle Scholar
  2. 2.
    Chihara D, Ito H, Matsuda T, Shibata A, Katsumi A, Nakamura S et al (2014) Differences in incidence and trends of haematological malignancies in Japan and the United States. Br J Haematol 164(4):536–545PubMedGoogle Scholar
  3. 3.
    Adams SV, Newcomb PA, Shustov AR (2016) Racial patterns of peripheral T-cell lymphoma incidence and survival in the United States. J Clin Oncol 34(9):963–971PubMedPubMedCentralGoogle Scholar
  4. 4.
    Suzuki R, Suzumiya J, Yamaguchi M, Nakamura S, Kameoka J, Kojima H et al (2010) Prognostic factors for mature natural killer (NK) cell neoplasms: aggressive NK cell leukemia and extranodal NK cell lymphoma, nasal type. Ann Oncol 21(5):1032–1040PubMedGoogle Scholar
  5. 5.
    Lee J, Suh C, Park YH, Ko YH, Bang SM, Lee JH et al (2006) Extranodal natural killer T-cell lymphoma, nasal-type: a prognostic model from a retrospective multicenter study. J Clin Oncol 24(4):612–618PubMedGoogle Scholar
  6. 6.
    A predictive model for aggressive non-Hodgkin’s lymphoma. The international non-Hodgkin’s lymphoma prognostic factors project. N Engl J Med 329(14):987–994 (1993)Google Scholar
  7. 7.
    Au WY, Weisenburger DD, Intragumtornchai T, Nakamura S, Kim WS, Sng I et al (2009) Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project. Blood 113(17):3931–3937PubMedGoogle Scholar
  8. 8.
    Kim WS, Song SY, Ahn YC, Ko YH, Baek CH, Kim DY et al (2001) CHOP followed by involved field radiation: is it optimal for localized nasal natural killer/T-cell lymphoma? Ann Oncol 12(3):349–352PubMedGoogle Scholar
  9. 9.
    Song SY, Kim WS, Ko YH, Kim K, Lee MH, Park K (2002) Aggressive natural killer cell leukemia: clinical features and treatment outcome. Haematologica 87(12):1343–1345PubMedGoogle Scholar
  10. 10.
    Nakashima Y, Tagawa H, Suzuki R, Karnan S, Karube K, Ohshima K et al (2005) Genome-wide array-based comparative genomic hybridization of natural killer cell lymphoma/leukemia: different genomic alteration patterns of aggressive NK-cell leukemia and extranodal Nk/T-cell lymphoma, nasal type. Genes Chromosom Cancer 44(3):247–255PubMedGoogle Scholar
  11. 11.
    Lima M, Almeida J, Montero AG, Teixeira Mdos A, Queiros ML, Santos AH et al (2004) Clinicobiological, immunophenotypic, and molecular characteristics of monoclonal CD56∓ dim chronic natural killer cell large granular lymphocytosis. Am J Pathol 165(4):1117–1127PubMedPubMedCentralGoogle Scholar
  12. 12.
    Rabbani GR, Phyliky RL, Tefferi A (1999) A long-term study of patients with chronic natural killer cell lymphocytosis. Br J Haematol 106(4):960–966PubMedGoogle Scholar
  13. 13.
    Oshimi K, Yamada O, Kaneko T, Nishinarita S, Iizuka Y, Urabe A et al (1993) Laboratory findings and clinical courses of 33 patients with granular lymphocyte-proliferative disorders. Leukemia 7(6):782–788PubMedGoogle Scholar
  14. 14.
    Huang Q, Chang KL, Gaal KK, Weiss LM (2005) An aggressive extranodal NK-cell lymphoma arising from indolent NK-cell lymphoproliferative disorder. Am J Surg Pathol 29(11):1540–1543PubMedGoogle Scholar
  15. 15.
    Ohno Y, Amakawa R, Fukuhara S, Huang CR, Kamesaki H, Amano H et al (1989) Acute transformation of chronic large granular lymphocyte leukemia associated with additional chromosome abnormality. Cancer 64(1):63–67PubMedGoogle Scholar
  16. 16.
    Takeuchi K, Yokoyama M, Ishizawa S, Terui Y, Nomura K, Marutsuka K et al (2010) Lymphomatoid gastropathy: a distinct clinicopathologic entity of self-limited pseudomalignant NK-cell proliferation. Blood 116(25):5631–5637PubMedGoogle Scholar
  17. 17.
    Mansoor A, Pittaluga S, Beck PL, Wilson WH, Ferry JA, Jaffe ES (2011) NK-cell enteropathy: a benign NK-cell lymphoproliferative disease mimicking intestinal lymphoma: clinicopathologic features and follow-up in a unique case series. Blood 117(5):1447–1452PubMedPubMedCentralGoogle Scholar
  18. 18.
    Emile JF, Boulland ML, Haioun C, Kanavaros P, Petrella T, Delfau-Larue MH et al (1996) CD5-CD56+ T-cell receptor silent peripheral T-cell lymphomas are natural killer cell lymphomas. Blood 87(4):1466–1473PubMedGoogle Scholar
  19. 19.
    Suzumiya J, Takeshita M, Kimura N, Kikuchi M, Uchida T, Hisano S et al (1994) Expression of adult and fetal natural killer cell markers in sinonasal lymphomas. Blood 83(8):2255–2260PubMedGoogle Scholar
  20. 20.
    Ohshima K, Suzumiya J, Shimazaki K, Kato A, Tanaka T, Kanda M et al (1997) Nasal T/NK cell lymphomas commonly express perforin and Fas ligand: important mediators of tissue damage. Histopathology 31(5):444–450PubMedGoogle Scholar
  21. 21.
    Mori N, Yatabe Y, Oka K, Kinoshita T, Kobayashi T, Ono T et al (1996) Expression of perforin in nasal lymphoma. Additional evidence of its natural killer cell derivation. Am J Pathol 149(2):699–705PubMedPubMedCentralGoogle Scholar
  22. 22.
    Wong KF, Chan JK, Kwong YL (1997) Identification of del(6)(q21q25) as a recurring chromosomal abnormality in putative NK cell lymphoma/leukaemia. Br J Haematol 98(4):922–926PubMedGoogle Scholar
  23. 23.
    Tien HF, Su IJ, Tang JL, Liu MC, Lee FY, Chen YC et al (1997) Clonal chromosomal abnormalities as direct evidence for clonality in nasal T/natural killer cell lymphomas. Br J Haematol 97(3):621–625PubMedGoogle Scholar
  24. 24.
    Karube K, Nakagawa M, Tsuzuki S, Takeuchi I, Honma K, Nakashima Y et al (2011) Identification of FOXO3 and PRDM1 as tumor-suppressor gene candidates in NK-cell neoplasms by genomic and functional analyses. Blood 118(12):3195–3204PubMedGoogle Scholar
  25. 25.
    Iqbal J, Kucuk C, Deleeuw RJ, Srivastava G, Tam W, Geng H et al (2009) Genomic analyses reveal global functional alterations that promote tumor growth and novel tumor suppressor genes in natural killer-cell malignancies. Leukemia 23(6):1139–1151PubMedGoogle Scholar
  26. 26.
    Suzuki R, Suzumiya J, Nakamura S, Aoki S, Notoya A, Ozaki S et al (2004) Aggressive natural killer-cell leukemia revisited: large granular lymphocyte leukemia of cytotoxic NK cells. Leukemia 18(4):763–770PubMedGoogle Scholar
  27. 27.
    Ito Y, Kimura H, Maeda Y, Hashimoto C, Ishida F, Izutsu K et al (2012) Pretreatment EBV-DNA copy number is predictive of response and toxicities to SMILE chemotherapy for extranodal NK/T-cell lymphoma, nasal type. Clin Cancer Res 18(15):4183–4190 An Official Journal of the American Association for Cancer ResearchPubMedGoogle Scholar
  28. 28.
    Suzuki R, Yamaguchi M, Izutsu K, Yamamoto G, Takada K, Harabuchi Y et al (2011) Prospective measurement of Epstein-Barr virus-DNA in plasma and peripheral blood mononuclear cells of extranodal NK/T-cell lymphoma, nasal type. Blood 118(23):6018–6022PubMedGoogle Scholar
  29. 29.
    Cai Q, Chen K, Young KH (2015) Epstein-Barr virus-positive T/NK-cell lymphoproliferative disorders. Exp Mol Med 47:e133PubMedPubMedCentralGoogle Scholar
  30. 30.
    Trambas C, Wang Z, Cianfriglia M, Woods G (2001) Evidence that natural killer cells express mini P-glycoproteins but not classic 170 kDa P-glycoprotein. Br J Haematol 114(1):177–184PubMedGoogle Scholar
  31. 31.
    Egashira M, Kawamata N, Sugimoto K, Kaneko T, Oshimi K (1999) P-glycoprotein expression on normal and abnormally expanded natural killer cells and inhibition of P-glycoprotein function by cyclosporin A and its analogue, PSC833. Blood 93(2):599–606PubMedGoogle Scholar
  32. 32.
    Yamaguchi M, Kita K, Miwa H, Nishii K, Oka K, Ohno T et al (1995) Frequent expression of P-glycoprotein/MDR1 by nasal T-cell lymphoma cells. Cancer 76(11):2351–2356PubMedGoogle Scholar
  33. 33.
    Li YX, Yao B, Jin J, Wang WH, Liu YP, Song YW et al (2006) Radiotherapy as primary treatment for stage IE and IIE nasal natural killer/T-cell lymphoma. J Clin Oncol 24(1):181–189PubMedGoogle Scholar
  34. 34.
    You JY, Chi KH, Yang MH, Chen CC, Ho CH, Chau WK et al (2004) Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK)/T-cell lymphoma: a single institute survey in Taiwan. Ann Oncol 15(4):618–625PubMedGoogle Scholar
  35. 35.
    Yang Y, Cao JZ, Lan SM, Wu JX, Wu T, Zhu SY et al (2017) Association of improved locoregional control with prolonged survival in early-stage extranodal nasal-type natural killer/T-cell lymphoma. JAMA Oncol 3(1):83–91PubMedGoogle Scholar
  36. 36.
    Kim GE, Cho JH, Yang WI, Chung EJ, Suh CO, Park KR et al (2000) Angiocentric lymphoma of the head and neck: patterns of systemic failure after radiation treatment. J Clin Oncol 18(1):54–63PubMedGoogle Scholar
  37. 37.
    Cheung MM, Chan JK, Lau WH, Foo W, Chan PT, Ng CS et al (1998) Primary non-Hodgkin’s lymphoma of the nose and nasopharynx: clinical features, tumor immunophenotype, and treatment outcome in 113 patients. J Clin Oncol 16(1):70–77PubMedGoogle Scholar
  38. 38.
    Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y et al (2009) Phase I/II study of concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: Japan clinical oncology group study JCOG0211. J Clin Oncol 27(33):5594–5600PubMedGoogle Scholar
  39. 39.
    Yamaguchi M, Tobinai K, Oguchi M, Ishizuka N, Kobayashi Y, Isobe Y et al (2012) Concurrent chemoradiotherapy for localized nasal natural killer/T-cell lymphoma: an updated analysis of the Japan clinical oncology group study JCOG0211. J Clin Oncol 30(32):4044–4046PubMedGoogle Scholar
  40. 40.
    Kim SJ, Kim K, Kim BS, Kim CY, Suh C, Huh J et al (2009) Phase II trial of concurrent radiation and weekly cisplatin followed by VIPD chemotherapy in newly diagnosed, stage IE to IIE, nasal, extranodal NK/T-cell lymphoma: consortium for improving survival of lymphoma study. J Clin Oncol 27(35):6027–6032PubMedGoogle Scholar
  41. 41.
    Kim SJ, Yang DH, Kim JS, Kwak JY, Eom HS, Hong DS et al (2014) Concurrent chemoradiotherapy followed by L-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study. Ann Hematol 93(11):1895–1901PubMedGoogle Scholar
  42. 42.
    Yoon DH, Kim SJ, Jeong SH, Shin DY, Bae SH, Hong J et al (2016) Phase II trial of concurrent chemoradiotherapy with L-asparaginase and MIDLE chemotherapy for newly diagnosed stage I/II extranodal NK/T-cell lymphoma, nasal type (CISL-1008). Oncotarget 7(51):85584–85591PubMedPubMedCentralGoogle Scholar
  43. 43.
    Wang L, Wang ZH, Chen XQ, Li YJ, Wang KF, Xia YF et al (2013) First-line combination of gemcitabine, oxaliplatin, and L-asparaginase (GELOX) followed by involved-field radiation therapy for patients with stage IE/IIE extranodal natural killer/T-cell lymphoma. Cancer 119(2):348–355PubMedGoogle Scholar
  44. 44.
    Jiang M, Zhang H, Jiang Y, Yang Q, Xie L, Liu W et al (2012) Phase 2 trial of “sandwich” L-asparaginase, vincristine, and prednisone chemotherapy with radiotherapy in newly diagnosed, stage IE to IIE, nasal type, extranodal natural killer/T-cell lymphoma. Cancer 118(13):3294–3301PubMedGoogle Scholar
  45. 45.
    Yamaguchi M, Kwong YL, Kim WS, Maeda Y, Hashimoto C, Suh C et al (2011) Phase II study of SMILE chemotherapy for newly diagnosed stage IV, relapsed, or refractory extranodal natural killer (NK)/T-cell lymphoma, nasal type: the NK-Cell Tumor Study Group study. J Clin Oncol 29(33):4410–4416PubMedGoogle Scholar
  46. 46.
    Kwong YL, Kim WS, Lim ST, Kim SJ, Tang T, Tse E et al (2012) SMILE for natural killer/T-cell lymphoma: analysis of safety and efficacy from the Asia Lymphoma Study Group. Blood 120(15):2973–2980PubMedGoogle Scholar
  47. 47.
    Kim SM, Park S, Oh DR, Ahn YC, Ko YH, Kim SJ et al (2016) Extra-nodal natural killer/T cell lymphoma in elderly patients: the impact of aging on clinical outcomes and treatment tolerability. Ann Hematol 95(4):581–591PubMedGoogle Scholar
  48. 48.
    Chan A, Tang T, Ng T, Shih V, Tay K, Tao M et al (2012) To SMILE or not: supportive care matters. J Clin Oncol 30(9):1015–1016. Author reply 6–7PubMedGoogle Scholar
  49. 49.
    Jaccard A, Gachard N, Marin B, Rogez S, Audrain M, Suarez F et al (2011) Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study. Blood 117(6):1834–1839PubMedGoogle Scholar
  50. 50.
    Zhou Z, Li X, Chen C, Li X, Zhang L, Li L et al (2014) Effectiveness of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of relapsed/refractory extranodal NK/T cell lymphoma: a retrospective study of 17 patients. Ann Hematol 93(11):1889–1894PubMedGoogle Scholar
  51. 51.
    Li X, Cui Y, Sun Z, Zhang L, Li L, Wang X et al (2016) DDGP versus SMILE in newly diagnosed advanced natural killer/T-cell lymphoma: a randomized controlled, multicenter, open-label study in China. Clin Cancer Res 22(21):5223–5228 An Official Journal of the American Association for Cancer ResearchPubMedGoogle Scholar
  52. 52.
    Gupta VG, Gogia A (2016) DDGP versus SMILE in NK/T-cell lymphoma-letter. Clin Cancer Res 22(16):4271 An Official Journal of the American Association for Cancer ResearchPubMedGoogle Scholar
  53. 53.
    Takahashi H, Sakai R, Hattori Y, Ohshima R, Kuwabara H, Hagihara M et al (2013) Successful disease control with L-asparaginase monotherapy for aggressive natural killer cell leukemia with severe hepatic failure. Leuk Lymphoma 54(3):662–664PubMedGoogle Scholar
  54. 54.
    Suzuki R (2010) Treatment of advanced extranodal NK/T cell lymphoma, nasal-type and aggressive NK-cell leukemia. Int J Hematol 92(5):697–701PubMedGoogle Scholar
  55. 55.
    Kim SJ, Yoon DH, Jaccard A, Chng WJ, Lim ST, Hong H et al (2016) A prognostic index for natural killer cell lymphoma after non-anthracycline-based treatment: a multicentre, retrospective analysis. Lancet Oncol 17(3):389–400PubMedGoogle Scholar
  56. 56.
    Yamaguchi M, Suzuki R, Oguchi M, Asano N, Amaki J, Akiba T et al (2017) Treatments and outcomes of patients with extranodal natural killer/T-cell lymphoma diagnosed between 2000 and 2013: a cooperative study in Japan. J Clin Oncol 35(1):32–39PubMedGoogle Scholar
  57. 57.
    Au WY, Pang A, Choy C, Chim CS, Kwong YL (2004) Quantification of circulating Epstein-Barr virus (EBV) DNA in the diagnosis and monitoring of natural killer cell and EBV-positive lymphomas in immunocompetent patients. Blood 104(1):243–249PubMedGoogle Scholar
  58. 58.
    Lei KI, Chan LY, Chan WY, Johnson PJ, Lo YM (2002) Diagnostic and prognostic implications of circulating cell-free Epstein-Barr virus DNA in natural killer/T-cell lymphoma. Clin Cancer Res 8(1):29–34 An Official Journal of the American Association for Cancer ResearchPubMedGoogle Scholar
  59. 59.
    Wang ZY, Liu QF, Wang H, Jin J, Wang WH, Wang SL et al (2012) Clinical implications of plasma Epstein-Barr virus DNA in early-stage extranodal nasal-type NK/T-cell lymphoma patients receiving primary radiotherapy. Blood 120(10):2003–2010PubMedGoogle Scholar
  60. 60.
    Wang L, Wang H, Wang JH, Xia ZJ, Lu Y, Huang HQ et al (2015) Post-treatment plasma EBV-DNA positivity predicts early relapse and poor prognosis for patients with extranodal NK/T cell lymphoma in the era of asparaginase. Oncotarget 6(30):30317–30326PubMedPubMedCentralGoogle Scholar
  61. 61.
    Suzuki R, Suzumiya J, Nakamura S, Kagami Y, Kameoka JI, Sakai C et al (2006) Hematopoietic stem cell transplantation for natural killer-cell lineage neoplasms. Bone Marrow Transpl 37(4):425–431Google Scholar
  62. 62.
    Kim HJ, Bang SM, Lee J, Kwon HC, Suh C, Kim HJ et al (2006) High-dose chemotherapy with autologous stem cell transplantation in extranodal NK/T-cell lymphoma: a retrospective comparison with non-transplantation cases. Bone Marrow Transpl 37(9):819–824Google Scholar
  63. 63.
    Au WY, Lie AK, Liang R, Kwong YL, Yau CC, Cheung MM et al (2003) Autologous stem cell transplantation for nasal NK/T-cell lymphoma: a progress report on its value. Ann Oncol 14(11):1673–1676PubMedGoogle Scholar
  64. 64.
    Lee J, Au WY, Park MJ, Suzumiya J, Nakamura S, Kameoka J et al (2008) Autologous hematopoietic stem cell transplantation in extranodal natural killer/T cell lymphoma: a multinational, multicenter, matched controlled study. Biol Blood Marrow Transpl 14(12):1356–1364Google Scholar
  65. 65.
    Yhim HY, Kim JS, Mun YC, Moon JH, Chae YS, Park Y et al (2015) Clinical outcomes and prognostic factors of up-front autologous stem cell transplantation in patients with extranodal natural killer/T cell lymphoma. Biol Blood Marrow Transpl 21(9):1597–1604Google Scholar
  66. 66.
    Murashige N, Kami M, Kishi Y, Kim SW, Takeuchi M, Matsue K et al (2005) Allogeneic haematopoietic stem cell transplantation as a promising treatment for natural killer-cell neoplasms. Br J Haematol 130(4):561–567PubMedGoogle Scholar
  67. 67.
    Tse E, Chan TS, Koh LP, Chng WJ, Kim WS, Tang T et al (2014) Allogeneic haematopoietic SCT for natural killer/T-cell lymphoma: a multicentre analysis from the Asia Lymphoma Study Group. Bone Marrow Transpl 49(7):902–906Google Scholar
  68. 68.
    Jung KS, Cho SH, Kim SJ, Ko YH, Kang ES, Kim WS (2016) L-asparaginase-based regimens followed by allogeneic hematopoietic stem cell transplantation improve outcomes in aggressive natural killer cell leukemia. J Hematol Oncol 9:41PubMedPubMedCentralGoogle Scholar
  69. 69.
    Hamadani M, Kanate AS, DiGilio A, Ahn KW, Smith SM, Lee JW et al (2017) Allogeneic hematopoietic cell transplantation for aggressive NK cell leukemia. Biol Blood Marrow Transpl. A Center for International Blood and Marrow Transplant Research AnalysisGoogle Scholar
  70. 70.
    Gottschalk S, Edwards OL, Sili U, Huls MH, Goltsova T, Davis AR et al (2003) Generating CTLs against the subdominant Epstein-Barr virus LMP1 antigen for the adoptive immunotherapy of EBV-associated malignancies. Blood 101(5):1905–1912PubMedGoogle Scholar
  71. 71.
    Bollard CM, Gottschalk S, Torrano V, Diouf O, Ku S, Hazrat Y et al (2014) Sustained complete responses in patients with lymphoma receiving autologous cytotoxic T lymphocytes targeting Epstein-Barr virus latent membrane proteins. J Clin Oncol 32(8):798–808PubMedGoogle Scholar
  72. 72.
    Armand P, Shipp MA, Ribrag V, Michot JM, Zinzani PL, Kuruvilla J et al (2016) Programmed death-1 blockade with pembrolizumab in patients with classical Hodgkin lymphoma after brentuximab vedotin failure. J Clin OncolGoogle Scholar
  73. 73.
    Ansell SM, Lesokhin AM, Borrello I, Halwani A, Scott EC, Gutierrez M et al (2015) PD-1 blockade with nivolumab in relapsed or refractory Hodgkin’s lymphoma. N Engl J Med 372(4):311–319PubMedGoogle Scholar
  74. 74.
    Kwong YL, Chan TS, Tan D, Kim SJ, Poon LM, Mow B et al (2017) PD1 blockade with pembrolizumab is highly effective in relapsed or refractory NK/T-cell lymphoma failing L-asparaginase. BloodGoogle Scholar
  75. 75.
    Lonial S, Weiss BM, Usmani SZ, Singhal S, Chari A, Bahlis NJ et al (2016) Daratumumab monotherapy in patients with treatment-refractory multiple myeloma (SIRIUS): an open-label, randomised, phase 2 trial. Lancet 387(10027):1551–1560PubMedGoogle Scholar
  76. 76.
    Hari P, Raj RV, Olteanu H (2016) Targeting CD38 in refractory extranodal natural killer cell-T-cell lymphoma. N Engl J Med 375(15):1501–1502PubMedGoogle Scholar
  77. 77.
    Kim SJ, Kim JH, Ki CS, Ko YH, Kim JS, Kim WS (2016) Epstein-Barr virus reactivation in extranodal natural killer/T-cell lymphoma patients: a previously unrecognized serious adverse event in a pilot study with romidepsin. Ann Oncol 27(3):508–513PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineThe University of New MexicoAlbuquerqueUSA
  2. 2.Department of Lymphoma/MyelomaThe University of Texas MD Anderson Cancer CenterHoustonUSA

Personalised recommendations