Nasal NK/T-cell lymphoma with disseminated disease treated with aggressive combined therapy

• Published in: Medical oncology (Northwood, London, England) London, England), 2003-01, Vol.20 (1), p.13-18
• Main Authors: Avilés, Agustin, Neri, Natividad, Fernández, Raúl, Calva, Angel, Huerta-Guzmán, Judith, Nambo, M Jesús
• Format: Article
• Language: English
• Subjects: Adult; Aged; Agranulocytosis - chemically induced; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Marrow Neoplasms - drug therapy; Bone Marrow Neoplasms - radiotherapy; Cyclophosphamide - administration & dosage; Dexamethasone - administration & dosage; Disease-Free Survival; Etoposide - administration & dosage; Female; Follow-Up Studies; Granulocyte Colony-Stimulating Factor - administration & dosage; Humans; Killer Cells, Natural - drug effects; Killer Cells, Natural - radiation effects; Leucovorin - administration & dosage; Lung Neoplasms - drug therapy; Lung Neoplasms - radiotherapy; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - radiotherapy; Male; Methotrexate - administration & dosage; Middle Aged; Nose Neoplasms - drug therapy; Nose Neoplasms - radiotherapy; Oncology; Radiotherapy, Adjuvant; Remission Induction; Skin Neoplasms - drug therapy; Skin Neoplasms - radiotherapy; Treatment Outcome
• ISSN: 1357-0560; 1357-0560; 1559-131X
• DOI: 10.1385/MO:20:1:13

Thirty-two patients with nasal NK/T-cell lymphoma and disseminated disease (lung, skin, and bone marrow) were treated with an intensive combined therapy that consisted of three cycles of CMED (cyclophosphamide 2 g/m(2), metothrexate 200 mg/m(2), etoposide 600 mg/m(2), and dexamethasone 80 mg/m(2) with leucovorin rescue administered 24 h after) every 14 d, following high-dose radiotherapy: 55 Gy in 20 sesions to centrofacial region and three cycles more of the same chemotherapy regimen. To ameliorate the presence of severe granulocytopenia, granulocyte colony-stimulating factor, 5 microg/kg, daily for 14 d, begun on d 2 after chemotherapy, was administered. Complete response was achieved in 21 cases (65%); failure or progression was observed in 11 cases (35%). With a median follow-up of 69.1 mo, relapse has not been observed; thus, actuarial curves at 5 yr showed that event-free survival (EFS) is 100% in 21 patients and overall survival (OS) is 65%. Granulocytopenia grade IV was observed in 15% cycles, Nonhematological toxicity was mild and well tolerated. Radiotherapy was well tolerated; only mild mucositis was observed. Nasal NK/T-cell lymphoma is an rare presentation of malignant lymphoma (