Hematology Department, Limoges University Hospital, Limoges, France.
Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM U1163, Imagine Institute, Université Paris Cité, Paris, France.
Br J Haematol. 2023 May;201(4):673-681. doi: 10.1111/bjh.18689. Epub 2023 Feb 17.
Extranodal NK/T-cell lymphoma, nasal type is a rare and aggressive form of lymphoma, historically associated with poor prognosis. We report here the results of a retrospective multi-centre study evaluating the efficacy of MGAD (methotrexate, gemcitabine, L-asparaginase and dexamethasone) regimen (two cycles) combined with 'sandwich' radiotherapy in 35 patients with localised newly diagnosed extranodal NK/T-cell lymphoma. Thirty-two patients (91%) reached complete remission. With a long median follow-up of 59.6 months, progression-free and overall survival at 2 and 5 years were 71%, 80% and 53%, 73%, respectively. Around one third of the patients experienced relapse within a median time of 14.5 months. Side-effects were manageable with grades 3-4 cytopenias, mucositis and infection in 50%, 24% and 21% of the cases, respectively. Monitoring of asparaginase activity was performed in 13 patients and showed inactivation of the drug in seven (54%) patients. Our results indicate that a short therapy by sandwich MGAD chemoradiotherapy is a tolerable and effective treatment option in localised newly diagnosed extranodal NK/T-cell lymphoma patients.
结外 NK/T 细胞淋巴瘤，鼻型是一种罕见且侵袭性的淋巴瘤，历史上与预后不良相关。我们在此报告一项回顾性多中心研究的结果，该研究评估了 MGAD（甲氨蝶呤、吉西他滨、L-天冬酰胺酶和地塞米松）方案（两个周期）联合“三明治”放疗在 35 例局部初诊结外 NK/T 细胞淋巴瘤患者中的疗效。32 例患者（91%）达到完全缓解。中位随访时间长达 59.6 个月，2 年和 5 年无进展生存率和总生存率分别为 71%、80%和 53%、73%。大约三分之一的患者在中位时间 14.5 个月内复发。在 50%、24%和 21%的病例中，分别有 3 级-4 级血细胞减少症、黏膜炎和感染等不良反应。在 13 例患者中监测了天冬酰胺酶的活性，发现 7 例（54%）患者药物失活。我们的结果表明，局部初诊结外 NK/T 细胞淋巴瘤患者采用短疗程三明治 MGAD 化放疗是一种可耐受且有效的治疗选择。
