Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Invest New Drugs. 2013 Apr;31(2):469-72. doi: 10.1007/s10637-012-9889-4. Epub 2012 Oct 28.
Extranodal natural killer/T-cell lymphoma (ENKL) has a dismal prognosis. Although L-asparaginase has shown promising efficacy as a frontline therapy, currently there are no treatment options after progression to an L-asparaginase-containing regimen. We report the results of gemcitabine-containing therapy in patients with relapsed or refractory ENKL. We retrospectively reviewed 20 patients with refractory or relapsed ENKL who received a gemcitabine-containing regimen between 2005 and 2011. The overall response rate was 40% (8 of 20 patients) with a complete response (CR) rate of 20% (n = 4) and a partial response (PR) rate of 20% (n = 4). Four complete responders had a disease-free status for more than 7 months including two patients received autologous stem cell transplantation consolidation and L-aspraginase maintenance, respectively. The median progression-free survival of the 20 patients was 2.3 months; however, it was 7.3 months for eight responders (CR and PR). The median overall survival of the eight responders had not been reached at the time of analysis. Gemcitabine was effective in a subset of pretreated ENKL patients and can be considered as a salvage option.
结外 NK/T 细胞淋巴瘤(ENKL)预后较差。虽然 L-天冬酰胺酶作为一线治疗已显示出良好的疗效,但在进展为含 L-天冬酰胺酶的方案后,目前尚无治疗选择。我们报告了在复发或难治性 ENKL 患者中使用含吉西他滨治疗的结果。我们回顾性分析了 2005 年至 2011 年间接受含吉西他滨方案治疗的 20 例难治性或复发性 ENKL 患者。总缓解率为 40%(20 例患者中有 8 例),完全缓解率为 20%(n=4),部分缓解率为 20%(n=4)。4 例完全缓解者无疾病状态持续时间超过 7 个月,其中 2 例分别接受了自体干细胞移植巩固和 L-天冬酰胺酶维持治疗。20 例患者的中位无进展生存期为 2.3 个月,而 8 例缓解者(CR 和 PR)的中位无进展生存期为 7.3 个月。分析时,8 例缓解者的中位总生存期尚未达到。吉西他滨对既往治疗的 ENKL 患者亚群有效,可作为挽救治疗的选择。