title: Management of advanced NK/T-cell lymphoma.
abstract: NK/T-cell lymphomas are aggressive malignancies, and the outlook is poor when conventional anthracycline-containing regimens designed for B-cell lymphomas are used. With the advent of L-asparaginase-containing regimens, treatment outcome has significantly improved. L-asparaginase-containing regimens are now considered the standard in the management of NK/T-cell lymphomas. In advanced diseases, however, outcome remains unsatisfactory, with durable remission achieved in only about 50% of cases. Stratification of patients with advanced NK/T-cell lymphomas is needed, so that poor-risk patients can be given additional therapy to improve outcome. Conventional presentation parameters are untested and appear inadequate for prognostication when L-asparaginase-containing regimens are used. Recent evidence suggests that dynamic factors during treatment and interim assessment, including Epstein-Barr virus (EBV) DNA quantification and positron emission tomography computed tomography findings, are more useful in patient stratification. The role of high-dose chemotherapy and haematopoietic stem cell transplantation requires evaluation in an overall risk-adapted treatment algorithm.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.
authors.forename: Eric
authors.initials: E
authors.lastname: Tse
authors.forename: Yok-Lam
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001215:Asparaginase / Q000627:therapeutic use*; D020031:Epstein-Barr Virus Infections / Q000097:blood; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000097:blood / Q000473:pathology / Q000628:therapy* / Q000821:virology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000970:Antineoplastic Agents; D001215:Asparaginase