Allogeneic hematopoietic stem cell transplant following chemotherapy containing l-asparaginase as a promising treatment for patients with relapsed or refractory extranodal natural killer/T cell lymphoma, nasal type

Leuk Lymphoma. 2010 Aug;51(8):1509-12. doi: 10.3109/10428194.2010.487958.

Abstract

The prognosis of advanced extranodal NK/T cell lymphoma (ENKTL) is poor. Allogeneic hematopoietic stem cell transplant (allo-HSCT) has been suggested to be a promising treatment for this disease, but its utility has yet to be established. Here we retrospectively analyzed five cases of ENKTL treated with allo-HSCT in our institute. After induction chemotherapy, disease status at allo-HSCT was second CR in three patients and refractory in two patients. All patients received a myeloablative conditioning regimen, and GVHD prophylaxis consisted of tacrolimus or cyclosporine with short-term methotrexate. Only one patient who received conventional induction chemotherapy developed severe complications, which needed long-term treatment, while others who received chemotherapy containing l-asparaginase did not have severe complications. There were no cases of treatment-related mortality, and all patients survived without disease for a median follow-up period of 1911 days. These results suggested that allo-HSCT following l-asparaginase-containing induction chemotherapy might improve the outcome of advanced ENKTL.

MeSH terms

  • Adult
  • Antineoplastic Agents / therapeutic use
  • Asparaginase / therapeutic use*
  • Combined Modality Therapy
  • Cyclosporine / therapeutic use
  • Drug Resistance, Neoplasm*
  • Female
  • Graft vs Host Disease / prevention & control*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lymphoma, T-Cell / pathology
  • Lymphoma, T-Cell / therapy*
  • Male
  • Methotrexate / therapeutic use
  • Natural Killer T-Cells / pathology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Nose Neoplasms / pathology
  • Nose Neoplasms / therapy*
  • Remission Induction
  • Retrospective Studies
  • Salvage Therapy
  • Survival Rate
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Antineoplastic Agents
  • Immunosuppressive Agents
  • Cyclosporine
  • Asparaginase
  • Methotrexate