Effectiveness of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of relapsed/refractory extranodal NK/T cell lymphoma: a retrospective study of 17 patients

• Published in: Annals of hematology 2014-11, Vol.93 (11), p.1889-1894
• Main Authors: Zhou, Zhiyuan, Li, Xiang, Chen, Changying, Li, Xin, Zhang, Lei, Li, Ling, Wang, Xinhua, Ma, Wang, Fu, Xiaorui, Wu, Jingjing, Sun, Zhenchang, Zhang, Xudong, Li, Zhaoming, Yan, Jiaqin, Chang, Yu, Lu, Lisha, Qin, Beibei, Li, Xiaoli, Wen, Jianguo, Zhang, Mingzhi
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Asparaginase - administration & dosage; Cisplatin - administration & dosage; Cohort Studies; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Dexamethasone - administration & dosage; Female; Hematology; Humans; Lymphoma, Extranodal NK-T-Cell - diagnosis; Lymphoma, Extranodal NK-T-Cell - drug therapy; Lymphoma, Extranodal NK-T-Cell - mortality; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Oncology; Original Article; Polyethylene Glycols - administration & dosage; Recurrence; Retrospective Studies; Survival Rate - trends; Treatment Outcome; Young Adult
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-014-2136-7

The prognosis of extranodal nature killer (NK)/T cell lymphoma (ENKL) is dismal because of its aggressive course and multidrug resistance. Currently, for patients with relapsed/refractory ENKL, l -asparaginase-based regimens such as l -asparaginase, ifosfamide, methotrexate, etoposide, and dexamethasone (SMILE) or l -asparaginase, methotrexate, and dexamethasone (AspaMetDex) are recommended. We retrospectively investigated the efficacy and safety of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of 17 relapsed/refractory ENKL patients. Clinical data from these patients were collected and analyzed. The primary end point was overall response rate (ORR). All patients were subjected to 2 to 6 cycles of DDGP chemotherapy, and the median number of cycles of DDGP regimen administrated was four. The ORR was 88.2 % (15/17), with nine patients (52.9 %) achieved complete response (CR) and six patients (35.3 %) achieved partial response (PR). The median follow-up time was 17 months (range 2–28 months). The 1-year overall survival (OS) rate and 1-year progression-free survival (PFS) were 82.4 and 64.7 %, respectively. For those CR responders, the median PFS was 17 months. Grade 3/4 neutropenia occurred in nine patients (52.9 %) and grade 3/4 thrombocytopenia occurred in six patients (35.3 %). DDGP combination chemotherapy produces favorable outcomes in relapsed/refractory ENKL, and more attention should be paid to treatment-related myelosuppression. Further prospective trials are expected to define the efficacy.