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Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study.
- Source :
-
Blood [Blood] 2011 Feb 10; Vol. 117 (6), pp. 1834-9. Date of Electronic Publication: 2010 Dec 01. - Publication Year :
- 2011
-
Abstract
- Extranodal NK/T-cell lymphoma, nasal type, is a rare and highly aggressive disease with a grim prognosis. No therapeutic strategy is currently identified in relapsing patients. We report the results of a French prospective phase II trial of an L-asparaginase-containing regimen in 19 patients with relapsed or refractory disease treated in 13 centers. Eleven patients were in relapse and 8 patients were refractory to their first line of treatment. L-Asparaginase-based treatment yielded objective responses in 14 of the 18 evaluable patients after 3 cycles. Eleven patients entered complete remission (61%), and only 4 of them relapsed. The median overall survival time was 1 year, with a median response duration of 12 months. The main adverse events were hepatitis, cytopenia, and allergy. The absence of antiasparaginase antibodies and the disappearance of Epstein-Barr virus serum DNA were significantly associated with a better outcome. These data confirm the excellent activity of L-asparaginase-containing regimens in extranodal NK/T-cell lymphoma. L-Asparaginase-based treatment should thus be considered for salvage therapy, especially in patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma warrants evaluation in prospective trials. This trial is registered at www.clinicaltrials.gov as #NCT00283985.
- Subjects :
- Aged
Antibodies blood
Asparaginase administration & dosage
Asparaginase immunology
DNA, Viral blood
Dexamethasone administration & dosage
Disease-Free Survival
Female
France
Herpesvirus 4, Human isolation & purification
Humans
Kaplan-Meier Estimate
Lymphoma, Extranodal NK-T-Cell immunology
Lymphoma, Extranodal NK-T-Cell virology
Male
Methotrexate administration & dosage
Middle Aged
Prognosis
Prospective Studies
Recurrence
Remission Induction
Salvage Therapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Lymphoma, Extranodal NK-T-Cell drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 117
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 21123825
- Full Text :
- https://doi.org/10.1182/blood-2010-09-307454