L-asparaginase-Based induction therapy for advanced extranodal NK/T-cell lymphoma.
We describe treatment of a patient with advanced extranodal NK/T-cell lymphoma, nasal type, with multiple subcutaneous lesions and hemophagocytic syndrome. Considering the projected poor outcome of conventional treatments, we designed an L-asparaginase-based induction therapy. L-asparaginase (4000 units/day, day 1 to day 7) combined with vincristine (1 mg, day 1) and prednisolone (100 mg/day, day 1 to day 5) was administered by intravenous infusion every 3 weeks. Within a week after treatment was started, excellent response was observed. Because of an allergic reaction to L-asparaginase, 6 courses of CHOP (adriamycin, cyclophosphamide, vincristine and prednisolone) therapy were administered as consolidation after 4 courses of L-asparaginase. The lymphoma was controlled with complete remission lasting longer than 2 years without additional treatment. These results and related reports may contribute to greater therapeutic efficacy against at least some cases of extranodal NK/T-cell lymphoma and other related diseases. Further evaluations based on clinical study are expected to clarify these results.
Obama
Kosuke
K
Department of Internal Medicine, Kagoshima City Hospital, Kagoshima, Japan. kobama@jiaikai.or.jp
Tara
Mitsutoshi
M
Niina
Kiyoshige
K
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001215:Asparaginase / Q000008:administration & dosage* / Q000009:adverse effects; D018572:Disease-Free Survival; D004342:Drug Hypersensitivity; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009669:Nose Neoplasms / Q000188:drug therapy / Q000473:pathology; D011239:Prednisolone / Q000008:administration & dosage; D012074:Remission Induction / Q000379:methods; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D011239:Prednisolone; D001215:Asparaginase