[Clinical characteristics and treatment of midline nasal and nasal type NK/T cell lymphoma].

OBJECTIVE

To study the clinical characteristics and treatment of midline nasal and nasal type T/Nk cell non-Hodgkin lymphoma.

METHODS

A retrospective study was made on the clinical characteristics, treatment, short-term effect, and two-year survival rate of 37 patients with midline nasal and nasal type T/NK non-Hodgkin lymphoma.

RESULTS

All of the patients were primarily treated with 2 cycles of CHOP chemotherapy. Ten of them were with good effect (common group). Then they were given 6 cycles of chemotherapy followed by focal radiotherapy and reached complete remission (CM). The other 27 patients failed to reach partial remission (PM) or even with their condition worsened after 2 cycles of CHOP regimen and were included into the refractory group. Fourteen of them received L-asparaginase-based salvage chemotherapy followed by focal radiotherapy (L-ASP group), and salvage therapy without L-ASP and followed by focal radiotherapy was given to the other 13 patients (non-L-ASP group). Continuous fever, angioinvasive growth and necrotic lesion could not be found among the patients in the common group. Their international prognostic indexes (IPI) were 0 approximately 1. Seventy percent of them were at the stages I or II. Continuous fever, angioinvasive growth and necrotic lesion could be found in the patients in refractory group. The IPIs among 85% of them were > 2, and 82% of them were at the stages III and IV. The CR rate was 46% for all patients as a whole, 100% for the common group, 26% for the refractory group (P < 0.005); and was 50% for the L-ASP group and 0% for the non-L-ASP group (P < 0.005). The 2-year survival rate was 43% for all patients as a whole, 100% for the common group, 20% for the refractory group (P < 0.005); and was 50.8% for the L-ASP group and 0% for the non-L-ASP group (P < 0.005).

CONCLUSION

Patients with midline nasal and nasal type T/NK non-Hodgkin lymphoma can be treated primarily by CHOP regimen and local radiotherapy. Refractory patients can be treated by salvage therapy based on L-ASP chemotherapy with a rather good effect. The clinical characteristics of most of the refractory patients include continuous fever, angioinvasive growth, necrotic lesion, being at stage III and IV, and with an IPI > 2.