L-Asparaginase in the treatment of refractory and relapsed extranodal NK/T-cell lymphoma, nasal type

Abstract

There is no standard salvage regimen for patients with refractory and relapsed extranodal NK/T-cell lymphoma (NKTCL), nasal type. This study was conduced to evaluate the efficacy of L-asparaginase-based regimen as a salvage regimen, on refractory and relapsed extranodal NKTCL, nasal type. Between March 1996 and March 2008, 45 patients with refractory and relapsed extranodal NKTCL, nasal type, were studied retrospectively. All patients were treated with L-asparaginase-based salvage regimen. Thirty-nine patients also received primary involved-field radiation after L-asparaginase-based chemotherapy. The complete response rate, partial response rate, and overall response rate for the whole group were 55.6%, 26.7%, and 82.2%, respectively. Both of 3-year and 5-year overall survival (OS) rates were 66.9%. The major adverse effects of L-asparaginase were myelosuppression, liver dysfunction, hyperglycemia, and allergic reaction. In general, the side effects could be tolerated. On univariate analysis, age, the stage of disease, and performance status were found to be prognostic factors influencing OS. On multivariate analysis, the stage of disease and age were independent prognostic factors for OS. L-Asparaginase-based regimen was obviously effective for the patients with refractory and relapsed extranodal NKTCL, nasal type.

Failure patterns and clinical implications in early stage nasal natural killer/T‐cell lymphoma treated with primary radiotherapy

“…With a novel risk stratification and more accurate staging methods, including improved imaging techniques and molecular markers, [35][36][37] future research should aim to determine whether these patients at high risk of systemic failure can benefit from innovative, more effective systemic therapies, such as new chemotherapeutic regimens and molecular targeted therapies. [38][39][40][41] The incidence of CNS involvement was largely diverse, mainly depending on the pathological subtype and stage of NHL. 42,43 Similarly to another study, 44 we found a very infrequent CNS relapse (1%) in patients with early stage nasal NK/T-cell lymphoma, not justifying the use of CNS chemoprophylaxis.…”

Current and future management of NK/T-cell lymphoma based on clinical trials

“…According to their latest publication [52], one to six cycles of chemotherapy with L-asparaginase, vincristine, and dexamethasone followed by IF-RT at a median dose of 50 Gy (range 30-60 Gy) were planned. Forty-one patients were evaluated in the study, with no statistical consideration for the sample size being reported.…”

Evolving therapy of peripheral T-cell lymphoma: 2010 and beyond

“…Furthermore, the relapse rate was high in both groups. The combination of CHOP and etoposide demonstrated a CR rate of 45% with a 3-year OS rate of 59% for nasal-type NK-cell lymphoma [Yong et al 2009]. …”