Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

Shapiro, Michael; Wasik, Mariusz A.; Junkins‐Hopkins, Jacqueline M.; Rook, Alain H.; Vittorio, Carmela C.; Itakura, Haruka; Frankel, Matthew C.; Georgala, S.; Schuster, Stephen J.

doi:10.1002/ajh.10381

Cited by 35 publications

(24 citation statements)

References 31 publications

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“…Following a second course of FLAG chemotherapy, the skin lesions were cured and BM remained in CR, which indicates that an intensive AML chemotherapy regimen may be more effective for extramedullary skin involvement than standard chemotherapy. In the FLAG regimen, Ara-C plays an important role in eliminating leukemic cells, while fludarabine is used to prolong the effective period of Ara-C. Shapiro et al [34] reported the effectiveness of another regimen, hyper-CVAD, for skin lesions of two elderly patients with blastic NK-cell lymphoma/leukemia. As the common feature of FLAG and hyper-CVAD regimen is high-dose Ara-C, our case may have responded with hyper-CVAD regimen.…”

Section: Discussionmentioning

confidence: 98%

Myeloid/natural killer cell precursor acute leukemia with multiple subcutaneous nodules as the initial presentation: a case report and literature review

Chen

et al. 2009

Int J Hematol

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Myeloid/natural killer (NK) cell precursor acute leukemia is a rare neoplasm, which is characterized by high incidence of extramedullary infiltration, especially in the mediastinum and lymph nodes, an aggressive course and poor prognosis. As coexpressing myeloid and NK-cell antigens, myeloid/NK-cell precursor acute leukemia (MNKL) may pose diagnostic difficulty. Because the developmental pathway of normal NK cells is not well understood, neoplams of NK-cell origin are not clearly identified. To our knowledge, there have been only about 30 cases with this disease published previously. In the current paper, we present a case of a 21-year-old male patient whose initial presentation showed numerous subcutaneous nodules without bone marrow involvement. A diagnosis of MNKL was finally made by skin biopsy, bone marrow immunohistochemistry and immunophenotypic analysis. Although bone marrow achieved complete remission using DA chemotherapeutic regimen, the skin nodules did not regress. However, FLAG chemotherapeutic regimen, including fludarabine, cytarabine and G-CSF, was effective for both bone marrow and skin involvement. To the best of our knowledge, this study is the first to describe the effect of FLAG regimen for the treatment of this disease, indicating that it may be effective against the skin involvement of MNKL.

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Section: Discussionmentioning

confidence: 98%

Myeloid/natural killer cell precursor acute leukemia with multiple subcutaneous nodules as the initial presentation: a case report and literature review

Chen

et al. 2009

Int J Hematol

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“…69 The M. D. Anderson Cancer Center used an alternating triple therapy regimen and hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone). 70 The GELA demonstrated that ACVBP had higher toxicity but superior event-free survival and OS compared with CHOP. 71 CHOP-14 proved superior to CHOP-21 or CHOP plus etoposide in elderly patients, 68 and CHOP plus etoposide should be used in younger patients.…”

Section: Therapeutic Approachesmentioning

confidence: 99%

Peripheral T-cell lymphoma

Foss

Zinzani

Vose

et al. 2011

Blood

276

226

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Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of clinically aggressive diseases associated with poor outcome. Studies that focus specifically on PTCL are emerging, with the ultimate goal of improved understanding of disease biology and the development of more effective therapies. However, one of the difficulties in classifying and studying treatment options in clinical trials is the rarity of these subtypes. Various groups have developed lymphoma classifications over the years, including the World Health Organization, which updated its classification in 2008. This article briefly reviews the major lymphoma classification schema, highlights contributions made by the collaborative International PTCL Project, discusses prognostic issues and gene expression profiling, and outlines therapeutic approaches to PTCL. These include the standard chemotherapeutic regimens and other modalities incorporating antifolates, conjugates, histone deacetylase inhibitors, monoclonal antibodies, nucleoside analogs, proteasome inhibitors, and signaling inhibitors. As this review emphasizes, the problem has now evolved into an abundance of drugs and too few patients available to test them. Collaborative groups will aid in future efforts to find the best treatment strategies to improve the outcome for patients with PTCL. (Blood. 2011;117(25): 6756-6767)

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“…Les leucé mies CD4+/CD56+ constituent une forme rare de leucé mie aiguë , maladie originale ré sultant d'une transformation lymphoïde apparenté e aux cellules dendritiques plasmocytoïdes DC2 [2,4,14]. Cette leucé mie aiguë survient à tout â ge, mais plus fré quemment chez les adultes de plus de 50 ans [3,10]. Elle peut ê tre primitive ou secondaire à une myé lodysplasie [3].…”

Section: Discussionunclassified

Leucémie aiguë CD4+/CD56+: à propos d’un cas clinique au service d’hématologie CHU Purpan, Toulouse (France)

2008

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Ré sumé : Les auteurs rapportent le cas d'une patiente porteuse d'une leucé mie aiguë (LA) CD4+/CD56+ considé ré e comme une forme rare de LA. L'expression des marqueurs CD4+/CD56+ ré sultent d'une transformation lymphoïde apparenté e aux cellules dendritiques plasmocytoïdes. Le tableau clinique de cette forme de LA est celui de lé sions cutané es infiltré es associé es à un syndrome tumoral ganglionnaire. Le diagnostic est apporté par l'immunohistochimie et/ou le mé dullogramme, qui retrouve une infiltration mé dullaire blastique massive qui exprime les marqueurs CD4+ et CD56+. L'immunophé notypage montre la né gativité des marqueurs T, B et des marqueurs myé loïdes, et à la cytogé né tique, des anomalies chromosomiques affectant les chromosomes 5, 9 et 15. Quel que soit le protocole de chimiothé -rapie et/ou de radiothé rapie choisi, le ré sultat est dé cevant, car les rechutes cutané es, systé miques et neurologiques sont fré quentes. La survie globale est de 52 % à un an pour les patients traité s par polychimiothé rapie et de 60 % aprè s allogreffe de moelle osseuse. Le pronostic est trè s mauvais, car aucune thé rapeutique actuelle ne permet d'obtenir une ré mission de plus de 5 ans. Mots clé s : Leucé mie aiguë CD4+/ CD56+ -Hé matodermieAcute leukaemia CD4+/CD56+: a case report in Purpan hospital, (Toulouse-France) Abstract: The authors report the case of a patient with acute leukaemia (AL) CD4+/CD56+ considered as the rare case of AL. These cells CD4+/CD56+ result from a lymphoid transformation related to the dendritic cells plasmocytoïdes. The clinical picture is the infiltrated cutaneous lesions associated a swollen glands syndrome. The diagnosis is suspected by cytology analysis and confirmed by immunophenotype and cytogenetic which finds a massive infiltration medullary blastic which expresses CD4+ and CD56+, the negativity of the markers T, B and the myeloid markers and cytogenetic abnormalities 5, 9 and 15. Whatever type or regimen of chemotherapy and radiotherapy is tried, the outcome remains dismal. The relapses are frequent and are especially in skin, marrow and central nervous system. The median survival at 1 year was 52% for the patients treated by polychemotherapy and 60% after allogenic bone marrow transplantation. Presently, no therapies have demonstrated remissions for 5 years or more.

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Complete remission in advanced blastic NK‐cell lymphoma/leukemia in elderly patients using the hyper‐CVAD regimen

Cited by 35 publications

References 31 publications

Myeloid/natural killer cell precursor acute leukemia with multiple subcutaneous nodules as the initial presentation: a case report and literature review

Myeloid/natural killer cell precursor acute leukemia with multiple subcutaneous nodules as the initial presentation: a case report and literature review

Peripheral T-cell lymphoma

Leucémie aiguë CD4+/CD56+: à propos d’un cas clinique au service d’hématologie CHU Purpan, Toulouse (France)

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