Obama Kosuke, Tara Mitsutoshi, Niina Kiyoshige
Department of Internal Medicine, Kagoshima City Hospital, Kagoshima, Japan.
Int J Hematol. 2003 Oct;78(3):248-50. doi: 10.1007/BF02983802.
We describe treatment of a patient with advanced extranodal NK/T-cell lymphoma, nasal type, with multiple subcutaneous lesions and hemophagocytic syndrome. Considering the projected poor outcome of conventional treatments, we designed an L-asparaginase-based induction therapy. L-asparaginase (4000 units/day, day 1 to day 7) combined with vincristine (1 mg, day 1) and prednisolone (100 mg/day, day 1 to day 5) was administered by intravenous infusion every 3 weeks. Within a week after treatment was started, excellent response was observed. Because of an allergic reaction to L-asparaginase, 6 courses of CHOP (adriamycin, cyclophosphamide, vincristine and prednisolone) therapy were administered as consolidation after 4 courses of L-asparaginase. The lymphoma was controlled with complete remission lasting longer than 2 years without additional treatment. These results and related reports may contribute to greater therapeutic efficacy against at least some cases of extranodal NK/T-cell lymphoma and other related diseases. Further evaluations based on clinical study are expected to clarify these results.
我们描述了一名晚期结外NK/T细胞淋巴瘤（鼻型）患者的治疗情况，该患者有多处皮下病变并伴有噬血细胞综合征。考虑到传统治疗方案预期效果不佳，我们设计了一种以左旋门冬酰胺酶为基础的诱导治疗方案。左旋门冬酰胺酶（4000单位/天，第1天至第7天）联合长春新碱（1毫克，第1天）和泼尼松龙（100毫克/天，第1天至第5天），每3周静脉输注一次。治疗开始后一周内，观察到显著疗效。由于对左旋门冬酰胺酶过敏，在4个疗程的左旋门冬酰胺酶治疗后，给予6个疗程的CHOP（阿霉素、环磷酰胺、长春新碱和泼尼松龙）治疗作为巩固治疗。淋巴瘤得到控制，完全缓解持续超过2年，无需额外治疗。这些结果及相关报告可能有助于提高对至少部分结外NK/T细胞淋巴瘤及其他相关疾病的治疗效果。基于临床研究的进一步评估有望阐明这些结果。
