Lai Jianping, Xu Peng, Jiang Xiaoliu, Zhou Shan, Liu Anwen
Department of oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
BMC Cancer. 2017 Jul 28;17(1):507. doi: 10.1186/s12885-017-3501-4.
Extranodal natural killer/T-cell lymphoma (NKTCL), nasal type, is an aggressive malignancy with poor prognosis. Currently, there is no recommended standard therapy for relapsed NKTCL.
A 37-year-old woman with lymphadenopathy was diagnosed with NKTCL by biopsy of an enlarged lymph node on the right side of her neck. Enhanced computed tomography revealed no metastasis. For this patient, we performed continuous chemotherapy followed by radiotherapy; however, nodule biopsy showed metastases in her lower limbs 3 months after radiotherapy, which confirmed disease progression. Unfortunately, the patient s temperature was persistently high and her skin ulcers could not be controlled well using multi-line treatment. Therefore, we attempted treatment with the anti-programmed-death-1 (PD-1) antibody, pembrolizumab. Surprisingly, the patient achieved clinical complete remission (CR) after four cycles of pembrolizumab treatment, despite having persistent detectable Epstein-Barr virus (EBV) DNA. Other molecular monitoring techniques were unavailable for this patient owing to the retrospective nature of the study. The only adverse event was soreness of the upper limb joints and muscles.
This relapsed NKTCL case treated with pembrolizumab showed that multimodal therapy including pembrolizumab would be partially or totally effective for relapsed NKTCL.
结外自然杀伤/T细胞淋巴瘤（NKTCL），鼻型，是一种侵袭性恶性肿瘤，预后较差。目前，对于复发的NKTCL尚无推荐的标准治疗方案。
一名37岁的淋巴结病女性患者，通过右侧颈部肿大淋巴结活检被诊断为NKTCL。增强计算机断层扫描显示无转移。对于该患者，我们先进行了持续化疗，随后进行放疗；然而，放疗3个月后结节活检显示其下肢有转移，这证实了疾病进展。不幸的是，患者体温持续升高，且采用多线治疗无法很好地控制其皮肤溃疡。因此，我们尝试使用抗程序性死亡1（PD-1）抗体帕博利珠单抗进行治疗。令人惊讶的是，尽管患者的爱泼斯坦-巴尔病毒（EBV）DNA持续可检测到，但在接受四个周期的帕博利珠单抗治疗后仍实现了临床完全缓解（CR）。由于本研究的回顾性性质，该患者无法采用其他分子监测技术。唯一的不良事件是上肢关节和肌肉酸痛。
该例用帕博利珠单抗治疗的复发NKTCL病例表明，包括帕博利珠单抗在内的多模式治疗对复发的NKTCL可能部分或完全有效。
