Effectiveness of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of relapsed/refractory extranodal NK/T cell lymphoma: a retrospective study of 17 patients.

Abstract

The prognosis of extranodal nature killer (NK)/T cell lymphoma (ENKL) is dismal because of its aggressive course and multidrug resistance. Currently, for patients with relapsed/refractory ENKL, L-asparaginase-based regimens such as L-asparaginase, ifosfamide, methotrexate, etoposide, and dexamethasone (SMILE) or L-asparaginase, methotrexate, and dexamethasone (AspaMetDex) are recommended. We retrospectively investigated the efficacy and safety of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of 17 relapsed/refractory ENKL patients. Clinical data from these patients were collected and analyzed. The primary end point was overall response rate (ORR). All patients were subjected to 2 to 6 cycles of DDGP chemotherapy, and the median number of cycles of DDGP regimen administrated was four. The ORR was 88.2 % (15/17), with nine patients (52.9 %) achieved complete response (CR) and six patients (35.3 %) achieved partial response (PR). The median follow-up time was 17 months (range 2-28 months). The 1-year overall survival (OS) rate and 1-year progression-free survival (PFS) were 82.4 and 64.7 %, respectively. For those CR responders, the median PFS was 17 months. Grade 3/4 neutropenia occurred in nine patients (52.9 %) and grade 3/4 thrombocytopenia occurred in six patients (35.3 %). DDGP combination chemotherapy produces favorable outcomes in relapsed/refractory ENKL, and more attention should be paid to treatment-related myelosuppression. Further prospective trials are expected to define the efficacy.

• Authors: Zhiyuan Zhou, Xiang Li, Changying Chen, Xin Li, Lei Zhang, Ling Li, Xinhua Wang, Wang Ma, Xiaorui Fu, Jingjing Wu, Zhenchang Sun, Xudong Zhang, Zhaoming Li, Jiaqin Yan, Yu Chang, Lisha Lu, Beibei Qin, Xiaoli Li, Jianguo Wen, Mingzhi Zhang
• Journal: Annals of hematology (Ann Hematol) Vol. 93 Issue 11 Pg. 1889-94 (Nov 2014) ISSN: 1432-0584 [Electronic] Germany
• PMID: 24923454 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Deoxycytidine
• Polyethylene Glycols
• pegaspargase
• Dexamethasone
• Asparaginase
• Cisplatin
• Gemcitabine

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Asparaginase (administration & dosage)
• Cisplatin (administration & dosage)
• Cohort Studies
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Dexamethasone (administration & dosage)
• Female
• Humans
• Lymphoma, Extranodal NK-T-Cell (diagnosis, drug therapy, mortality)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnosis, drug therapy, mortality)
• Polyethylene Glycols (administration & dosage)
• Recurrence
• Retrospective Studies
• Survival Rate (trends)
• Treatment Outcome
• Young Adult
• Gemcitabine