Dexamethasone, methotrexate, ifosfamide, l-asparaginase and etoposide (SMILE) chemotherapy for relapsed or refractory adult lymphoblastic lymphoma

摘要

Lymphoblastic lymphoma (LBL) is a neoplasm of precursor cells committed to the B- or T-cell lineage. Because the World Health Organization considers LBL and acute lymphoblastic leukemia (ALL) to be the same disease, their classification system calls LBL a precursor B- or T-lymphoblastic leukemia [1,2]. Although LBL has a poor prognosis when treated with conventional chemotherapy regimens [3], the application of an ALL treatment strategy, including pediatric-inspired regimens, has improved its treatment outcome. The hyper-fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone (Hyper-CVAD) regimen, one of the most common pediatric-inspired regimens, has produced complete response rates of 55-100% and disease-free survival rates between 45 and 65%; these numbers coincide with pediatric treatment data [3-5].