title: Efficacy and tolerance of pegaspargase-based chemotherapy in patients with nasal-type extranodal NK/T-cell lymphoma: a pilot study.
abstract: Nasal-type extranodal natural killer (NK)/T-cell lymphoma (ENKL) is a highly invasive cancer with a poor prognosis. More effective and safer treatment regimens for ENKL are needed. Pegaspargase (PEG-Asp) has a similar mechanism of action to L-asparaginase (L-Asp), but presents lower antigenicity. The aim of the present research was to evaluate the safety profile and the latent efficacy of a PEG-Asp-based treatment regimen in patients with ENKL. Data collected from 20 patients with histologically confirmed ENKL, admitted to the Third Affiliated Hospital of Sun Yat-Sen University from January 2009 to August 2013, were included in the study. All patients received 2500 IU/m2/IM PEG-Asp on day 1 of every 21-day treatment cycle. Patients received combination chemotherapy with CHOP (n=5), EPOCH (n=7), GEMOX (n=7) or CHOP with bleomycin (n=1). After 2-5 treatment cycles (median, 4 cycles) of PEG-Asp-based chemotherapy, five patients (25%) showed a complete response (CR), and the overall response rate (ORR) was 60%. Grade 3/4 neutropenia occurred in fourteen patients (70%). Grade 3 alanine aminotransferase (ALT) elevation was observed in two. Grade 1-2 non-hematological toxicity consisted of activated partial thromboplastin time (APTT) elongation (n=9), hypofibrinogenemia (n=6), hypoproteinemia (n=17), hyperglycemia (n=3), and nausea (n=6). No allergic reactions were detected. No treatment related death was reported. Our results suggested that PEG-Asp-based chemotherapy presented an acceptable tolerance and a potential short-term outcome in patients with nasal-type ENKL.
authors.affiliation: Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China E-mail : wuxiangy@mail.sysu.edu.cn.
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wen
authors.forename: Mai
authors.initials: M
authors.lastname: Li
authors.forename: Xing
authors.initials: X
authors.lastname: Li
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.forename: Xiao-kun
authors.initials: XK
authors.lastname: Ma
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.forename: Li
authors.initials: L
authors.lastname: Wei
authors.forename: Zhan-Hong
authors.initials: ZH
authors.lastname: Chen
authors.forename: Xiang-Yuan
authors.initials: XY
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001215:Asparaginase / Q000008:administration & dosage*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D009669:Nose Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010865:Pilot Projects; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D055815:Young Adult
chemical_list: D011092:Polyethylene Glycols; C042705:pegaspargase; D001215:Asparaginase