2016
DOI: 10.1002/hon.2325
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A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T‐cell lymphoma, nasal type: a multicenter trial in Northwest China

Abstract: The nasal type of extranodal natural killer/T‐cell lymphoma is a rare aggressive lymphoma with poor prognosis. To discover a successful treatment, we investigated the efficacy and safety of chemotherapy with methotrexate, etoposide, dexamethasone, and polyethylene glycol‐asparaginase (MESA). Three cycles of MESA were administered to 46 patients with new or relapsed/refractory natural killer/T‐cell lymphoma. Complete response after 3 treatment cycles was 43.5%, the overall response rate was 87%, and 2‐year over… Show more

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Cited by 19 publications
(18 citation statements)
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“…19,20 Common side effects related to pegaspargase include liver dysfunction, coagulation dysfunction, hypoalbuminemia, and hypertriglyceridemia. 21,22 This study showed that only one patient experienced grade 3/4 hypofibrinogenemia in the DDGP group. Liver dysfunction caused by pegaspargase was grade 1/2 and could be well controlled with supportive treatments.…”
Section: Discussionmentioning
confidence: 79%
“…19,20 Common side effects related to pegaspargase include liver dysfunction, coagulation dysfunction, hypoalbuminemia, and hypertriglyceridemia. 21,22 This study showed that only one patient experienced grade 3/4 hypofibrinogenemia in the DDGP group. Liver dysfunction caused by pegaspargase was grade 1/2 and could be well controlled with supportive treatments.…”
Section: Discussionmentioning
confidence: 79%
“…Comparing with l -asparaginase, pegaspargase depletes asparagine more efficiently by achieving rapid peak levels, with significant reduction of hypersensitive reactions and dose frequencies ( Fu and Sakamoto, 2007 , Shrivastava et al, 2016 ). Methotrexate (at a dose of 2–3 g/m 2 ) in combination with etoposide, dexamethasone, and pegaspargase has been recently reported on refractory or de novo ENKTL patients ( Ding et al, 2015 , Liang et al, 2016 ). With regards to the severe toxicity of high-dose methotrexate (reviewed in Table 2 ) and the dose-independent anti-ENKTL activity of methotrexate in vitro ( Kim et al, 2014b ) here we reduced the dose of methotrexate to 1 g/m 2 , as suggested in HyperCVAD/MA regimen ( Cortes et al, 1995 ) and evaluated the efficacy and toxicity of MESA as a first-line treatment on early-stage ENKTL.…”
Section: Discussionmentioning
confidence: 99%
“…The necessity of methotrexate has been examined in the ongoing clinical trial (NCT00283985). The same regimen without radiotherapy has shown satisfactory results (95). Another regimen of the sandwich protocol was reported, Jiang et al presented the protocol using L-asparaginase, cisplatin, dexamethasone and etoposide sandwiched with radiotherapy (96).…”
Section: Nnktl Treatmentmentioning
confidence: 99%