title: A phase 2 study of methotrexate, etoposide, dexamethasone, and pegaspargase chemotherapy for newly diagnosed, relapsed, or refractory extranodal natural killer/T-cell lymphoma, nasal type: a multicenter trial in Northwest China.
abstract: The nasal type of extranodal natural killer/T-cell lymphoma is a rare aggressive lymphoma with poor prognosis. To discover a successful treatment, we investigated the efficacy and safety of chemotherapy with methotrexate, etoposide, dexamethasone, and polyethylene glycol-asparaginase (MESA). Three cycles of MESA were administered to 46 patients with new or relapsed/refractory natural killer/T-cell lymphoma. Complete response after 3 treatment cycles was 43.5%, the overall response rate was 87%, and 2-year overall survival was 83.4%. Complete response was significantly better for newly diagnosed patients than for patients with relapsed/refractory disease. Patients with newly diagnosed disease had a significantly better overall response rate after 1, but not after 2 or 3 treatment cycles. Overall survival and progression-free survival did not differ over 2 years. Grade 1/2 toxicities were frequent, but MESA was associated with fewer grade 3/4 events or treatment-related deaths. These results will require confirmation in larger prospective trials.
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Liang
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Guang-Xun
authors.initials: GX
authors.lastname: Gao
authors.affiliation: Department of Hematology, Xinan Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jie-Ping
authors.initials: JP
authors.lastname: Chen
authors.affiliation: Department of Hematology, Guiyang Medical University, Guiyang, Guizhou Province, China.
authors.forename: Ji-Shi
authors.initials: JS
authors.lastname: Wang
authors.affiliation: Department of Hematology, Xinjiang Autonomous Region Hospital, Wulumuqi, Xinjiang Autonomous Region, China.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Wang
authors.affiliation: Department of Hematology, The Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Qing-Xian
authors.initials: QX
authors.lastname: Bai
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Bao-Xia
authors.initials: BX
authors.lastname: Dong
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Hong-Tao
authors.initials: HT
authors.lastname: Gu
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Mi-Mi
authors.initials: MM
authors.lastname: Shu
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Hao
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Na
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Xijing Hospital, Fourth Military Medical University, 710032, Xi'an, Shaanxi Province, China.
authors.forename: Xie-Qun
authors.initials: XQ
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001215:Asparaginase / Q000008:administration & dosage; D015415:Biomarkers; D002681:China; D003907:Dexamethasone / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D053208:Kaplan-Meier Estimate; D054391:Lymphoma, Extranodal NK-T-Cell / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011379:Prognosis; D012008:Recurrence; D019233:Retreatment; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011092:Polyethylene Glycols; D005047:Etoposide; C042705:pegaspargase; D003907:Dexamethasone; D001215:Asparaginase; D008727:Methotrexate
keywords: chemotherapy; clinical trial; extranodal NK/T-cell lymphoma; lymphoma; nasal type; non-Hodgkin; refractory; relapse