Efficacy of a short sandwich protocol, methotrexate, gemcitabine, L-asparaginase and dexamethasone chemotherapy combined with radiotherapy, in localised newly diagnosed NK/T-cell lymphoma: A French retrospective study.
Chaubard S,Marouf A,Lavergne D,Lemonnier F,Rossignol J,Clavert A,Gressin R,Cartron G,Waultier-Rascalou A,Vargaftig J,Salles G,Bachy E,Ghesquières H,Tournilhac O,Chauchet A,Le Gouill S,Damaj G,Fornecker L,Sibon D,Obéric L,Michot J,Gaulard P,Hermine O,Couronné L,Jaccard A
Source :
Br J Haematol
2023 Fév 17
Pmid / DOI:
36799516
Abstract
Extranodal NK/T-cell lymphoma, nasal type is a rare and aggressive form of lymphoma, historically associated with poor prognosis. We report here the results of a retrospective multi-centre study evaluating the efficacy of MGAD (methotrexate, gemcitabine, L-asparaginase and dexamethasone) regimen (two cycles) combined with 'sandwich' radiotherapy in 35 patients with localised newly diagnosed extranodal NK/T-cell lymphoma. Thirty-two patients (91%) reached complete remission. With a long median follow-up of 59.6 months, progression-free and overall survival at 2 and 5 years were 71%, 80% and 53%, 73%, respectively. Around one third of the patients experienced relapse within a median time of 14.5 months. Side-effects were manageable with grades 3-4 cytopenias, mucositis and infection in 50%, 24% and 21% of the cases, respectively. Monitoring of asparaginase activity was performed in 13 patients and showed inactivation of the drug in seven (54%) patients. Our results indicate that a short therapy by sandwich MGAD chemoradiotherapy is a tolerable and effective treatment option in localised newly diagnosed extranodal NK/T-cell lymphoma patients.KEYWORDSNK-T cell lymphoma, asparaginase activity, non-Hodgkin lymphoma, radio-chemotherapy© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.