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基于L-天冬酰胺酶治疗15例西方结外NK/T细胞淋巴瘤和白血病患者并文献复习

L-asparaginase-based treatment of 15 western patients with extranodal NK/T-cell lymphoma and leukemia and a review of the literature.

作者信息

Jaccard A, Petit B, Girault S, Suarez F, Gressin R, Zini J-M, Coiteux V, Larroche C, Devidas A, Thiéblemont C, Gaulard P, Marin B, Gachard N, Bordessoule D, Hermine O

机构信息

Department of Hematology, Centre Hospitalier Universitaire, Limoges, France.

出版信息

Ann Oncol. 2009 Jan;20(1):110-6. doi: 10.1093/annonc/mdn542. Epub 2008 Aug 13.

Abstract

BACKGROUND

Extranodal natural killer (NK)/T-cell lymphoma, nasal type, and aggressive NK-cell leukemia are highly aggressive diseases with a poor outcome.

PATIENTS AND METHODS

We report a multicentric French retrospective study of 15 patients with relapsed, refractory, or disseminated disease, treated with L-asparaginase-containing regimens in seven French centers. Thirteen patients were in relapse and/or refractory and 10 patients were at stage IV.

RESULTS

All but two of the patients had an objective response to L-asparaginase-based treatment. Seven patients reached complete remission and only two relapsed.

CONCLUSION

These data, although retrospective, confirm the excellent activity of L-asparaginase-containing regimens in refractory extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia. Therefore, L-asparaginase-based regimen should be considered as a salvage treatment, especially for patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia should be tested in prospective trials.

摘要

背景

结外自然杀伤(NK)/T细胞淋巴瘤,鼻型,以及侵袭性NK细胞白血病是高度侵袭性疾病,预后较差。

患者与方法

我们报告一项法国多中心回顾性研究,对15例复发、难治或播散性疾病患者采用含左旋门冬酰胺酶的方案进行治疗,这些患者来自法国的7个中心。13例患者处于复发和/或难治状态,10例患者处于IV期。

结果

除2例患者外,所有患者对基于左旋门冬酰胺酶的治疗均有客观反应。7例患者达到完全缓解,仅2例复发。

结论

这些数据虽然是回顾性的,但证实了含左旋门冬酰胺酶方案在难治性结外NK/T细胞淋巴瘤和侵袭性NK细胞白血病中具有出色的活性。因此,基于左旋门冬酰胺酶的方案应被视为挽救治疗方案,尤其是对于播散性疾病患者。结外NK/T细胞淋巴瘤和侵袭性NK细胞白血病的一线左旋门冬酰胺酶联合治疗应在前瞻性试验中进行测试。

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