Efficacy of pegaspargase, etoposide, methotrexate and dexamethasone in newly diagnosed advanced-stage extra-nodal natural killer/T-cell lymphoma with the analysis of the prognosis of whole blood EBV-DNA

摘要

Extra-nodal natural-killer (NK)/T-cell lymphoma (ENKTL) is an aggressive disease common in Asia but rare in the West. More than two-thirds of persons have stage-I/II disease of the upper aero-digestive tract. 1 , 2 , 3 These persons often respond to radiation therapy with or without anti-cancer drugs but relapse is common. 4 , 5 Anthracycline-based regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) are often used to treat advanced-stage disease but are ineffective with overall survival (OS) less than a year. 3 Recently, L -asparaginase-based regimens were shown to be more active. 6 , 7 , 8 The SMILE regimen ( L -asparaginase, etoposide, methotrexate, ifosfamide and dexamethasone) regimen is reportedly effective in newly diagnosed persons with advanced-stage disease. 7 , 8 A regimen of modified SMILE was also reported to be effective by Yang et al. 6 We tested a regimen of PEMD (pegaspargase, etoposide, methotrexate and dexamethasone) in 32 newly diagnosed advanced-stage subjects with ENKTL.