title: 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.
abstract: The prognosis of extranodal nature killer (NK)/T cell lymphoma (ENKL) is dismal because of its aggressive course and multidrug resistance. Currently, for patients with relapsed/refractory ENKL, L-asparaginase-based regimens such as L-asparaginase, ifosfamide, methotrexate, etoposide, and dexamethasone (SMILE) or L-asparaginase, methotrexate, and dexamethasone (AspaMetDex) are recommended. We retrospectively investigated the efficacy and safety of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of 17 relapsed/refractory ENKL patients. Clinical data from these patients were collected and analyzed. The primary end point was overall response rate (ORR). All patients were subjected to 2 to 6 cycles of DDGP chemotherapy, and the median number of cycles of DDGP regimen administrated was four. The ORR was 88.2 % (15/17), with nine patients (52.9 %) achieved complete response (CR) and six patients (35.3 %) achieved partial response (PR). The median follow-up time was 17 months (range 2-28 months). The 1-year overall survival (OS) rate and 1-year progression-free survival (PFS) were 82.4 and 64.7 %, respectively. For those CR responders, the median PFS was 17 months. Grade 3/4 neutropenia occurred in nine patients (52.9 %) and grade 3/4 thrombocytopenia occurred in six patients (35.3 %). DDGP combination chemotherapy produces favorable outcomes in relapsed/refractory ENKL, and more attention should be paid to treatment-related myelosuppression. Further prospective trials are expected to define the efficacy.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450052, China.
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Zhou
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Changying
authors.initials: C
authors.lastname: Chen
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.forename: Xinhua
authors.initials: X
authors.lastname: Wang
authors.forename: Wang
authors.initials: W
authors.lastname: Ma
authors.forename: Xiaorui
authors.initials: X
authors.lastname: Fu
authors.forename: Jingjing
authors.initials: J
authors.lastname: Wu
authors.forename: Zhenchang
authors.initials: Z
authors.lastname: Sun
authors.forename: Xudong
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhaoming
authors.initials: Z
authors.lastname: Li
authors.forename: Jiaqin
authors.initials: J
authors.lastname: Yan
authors.forename: Yu
authors.initials: Y
authors.lastname: Chang
authors.forename: Lisha
authors.initials: L
authors.lastname: Lu
authors.forename: Beibei
authors.initials: B
authors.lastname: Qin
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Li
authors.forename: Jianguo
authors.initials: J
authors.lastname: Wen
authors.forename: Mingzhi
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001215:Asparaginase / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D011092:Polyethylene Glycols; C042705:pegaspargase; D003907:Dexamethasone; D001215:Asparaginase; D002945:Cisplatin; D000093542:Gemcitabine