title: Efficacy of a pegaspargase-based regimen in the treatment of newly-diagnosed extranodal natural killer/T-cell lymphoma.
abstract: Extranodal natural killer (NK)/T-cell lymphoma (ENKL) is an aggressive neoplasm with poor prognosis. Currently, there is no consensus on the optimal treatment of this disease. In this study, we report the efficacy of a pegaspargase (PEG-Asp)-based chemotherapy, a DDGP regimen (PEG-Asp, dexamethasone, cisplatin, gemcitabine), for the treatment of newly-diagnosed ENKL. From August 2010 to May 2012, 12 patients with newly-diagnosed stage II - IV ENKL were initially treated with a DDGP regimen in our center. Ten patients (10/12, 83.3%) achieved complete response (CR) and two (2/12, 16.7%) achieved partial response (PR). The objective overall response rate (ORR) was 100%. Three patients (3/12, 25.0%) relapsed, and as a result, two died of disease. Eight patients (8/12, 66.7%) were alive with no evidence of disease (NOD) after a median follow-up of 19 months (range 16 - 31 months). Hematologic toxicity was the most frequent toxicity reported in this study. Grade 3/4 leukopenia and neutropenia were common and both occurred in eight patients (8/12, 66.7%), respectively. Additionally, six patients (6/12, 50.0%) experienced grade 3/4 thrombocytopenia and three (3/12, 25.0%) experienced grade 3/4 anemia. However, no patient died of hematologic toxicity. Our results demonstrate the significant efficacy and safety profile of a DDGP regimen in the treatment of newly-diagnosed ENKL, and indicate the potential of this regimen as a first-line therapy against this disease.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.forename: L
authors.initials: L
authors.lastname: Zhang
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: J J
authors.initials: JJ
authors.lastname: Wu
authors.forename: Z C
authors.initials: ZC
authors.lastname: Sun
authors.forename: X R
authors.initials: XR
authors.lastname: Fu
authors.forename: X H
authors.initials: XH
authors.lastname: Wang
authors.forename: Y
authors.initials: Y
authors.lastname: Chang
authors.forename: R
authors.initials: R
authors.lastname: Wang
authors.forename: Y J
authors.initials: YJ
authors.lastname: Qiu
authors.forename: M Z
authors.initials: MZ
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001215:Asparaginase / Q000008:administration & dosage* / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003907:Dexamethasone / Q000008:administration & dosage; D064420:Drug-Related Side Effects and Adverse Reactions / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D012074:Remission Induction; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D011092:Polyethylene Glycols; C042705:pegaspargase; D003907:Dexamethasone; D001215:Asparaginase; D002945:Cisplatin; D000093542:Gemcitabine
keywords: pegaspargase, extranodal NK/T-cell lymphoma, non-Hodgkin's lymphoma, medical oncology