Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study
Journal article

Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study

  • Jaccard, Arnaud Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
  • Gachard, Nathalie Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
  • Marin, Benoit CHU Limoges, Unité Fonctionnelle de Recherche Clinique et Biostatistique, Limoges, France;
  • Rogez, Sylvie CHU Limoges, Laboratoire de Virologie, Limoges, France;
  • Audrain, Marie CHU Nantes, Laboratoire d'Immunologie, Nantes, France;
  • Suarez, Felipe Hôpital Necker, Paris, service d'Hématologie Clinique Université Paris Descartes, CNRS UMR 8147, Centre de Référence des Mastocytoses, Paris, France;
  • Tilly, Hervé Centre Henri Becquerel, Rouen, France;
  • Morschhauser, Franck CHU Lille, Service Maladies du Sang, Lille, France;
  • Thieblemont, Catherine Hôpital Saint Louis, service d'Hématologie Oncologie, Paris, France;
  • Ysebaert, Loic CHU Toulouse Purpan, service d'Hématologie, Toulouse, France;
  • Devidas, Alain Hôpital du Sud-Francilien, Corbeil, France;
  • Petit, Barbara Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
  • de Leval, Laurence Institut de Pathologie, CHU V, Université de Lausanne, Lausanne, Switzerland; and
  • Gaulard, Philippe Hôpital Henri-Mondor, Créteil, Département de Pathologie, Inserm U955, Créteil, France
  • Feuillard, Jean Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
  • Bordessoule, Dominique Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
  • Hermine, Olivier Hôpital Necker, Paris, service d'Hématologie Clinique Université Paris Descartes, CNRS UMR 8147, Centre de Référence des Mastocytoses, Paris, France;
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Published in:
  • Blood. - American Society of Hematology. - 2011, vol. 117, no. 6, p. 1834-1839
English Abstract
Extranodal NK/T-cell lymphoma, nasal type, is a rare and highly aggressive disease with a grim prognosis. No therapeutic strategy is currently identified in relapsing patients. We report the results of a French prospective phase II trial of an L-asparaginase-containing regimen in 19 patients with relapsed or refractory disease treated in 13 centers. Eleven patients were in relapse and 8 patients were refractory to their first line of treatment. L-Asparaginase–based treatment yielded objective responses in 14 of the 18 evaluable patients after 3 cycles. Eleven patients entered complete remission (61%), and only 4 of them relapsed. The median overall survival time was 1 year, with a median response duration of 12 months. The main adverse events were hepatitis, cytopenia, and allergy. The absence of antiasparaginase antibodies and the disappearance of Epstein-Barr virus serum DNA were significantly associated with a better outcome. These data confirm the excellent activity of L-asparaginase–containing regimens in extranodal NK/T-cell lymphoma. L-Asparaginase–based treatment should thus be considered for salvage therapy, especially in patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma warrants evaluation in prospective trials. This trial is registered at www.clinicaltrials.gov as #NCT00283985.
Language
  • English
Open access status
closed
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Persistent URL
https://sonar.ch/global/documents/150488
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