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
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Jaccard, Arnaud
Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
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Gachard, Nathalie
Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
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Marin, Benoit
CHU Limoges, Unité Fonctionnelle de Recherche Clinique et Biostatistique, Limoges, France;
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Rogez, Sylvie
CHU Limoges, Laboratoire de Virologie, Limoges, France;
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Audrain, Marie
CHU Nantes, Laboratoire d'Immunologie, Nantes, France;
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Suarez, Felipe
Hôpital Necker, Paris, service d'Hématologie Clinique Université Paris Descartes, CNRS UMR 8147, Centre de Référence des Mastocytoses, Paris, France;
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Tilly, Hervé
Centre Henri Becquerel, Rouen, France;
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Morschhauser, Franck
CHU Lille, Service Maladies du Sang, Lille, France;
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Thieblemont, Catherine
Hôpital Saint Louis, service d'Hématologie Oncologie, Paris, France;
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Ysebaert, Loic
CHU Toulouse Purpan, service d'Hématologie, Toulouse, France;
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Devidas, Alain
Hôpital du Sud-Francilien, Corbeil, France;
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Petit, Barbara
Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
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de Leval, Laurence
Institut de Pathologie, CHU V, Université de Lausanne, Lausanne, Switzerland; and
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Gaulard, Philippe
Hôpital Henri-Mondor, Créteil, Département de Pathologie, Inserm U955, Créteil, France
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Feuillard, Jean
Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
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Bordessoule, Dominique
Centre Hospitalier Universitaire (CHU) Limoges, Université et Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Recherche (UMR) 6101, Limoges, France;
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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.
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Open access status
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closed
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Persistent URL
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https://sonar.ch/global/documents/150488
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