DDGP versus SMILE in Newly Diagnosed Advanced Natural Killer/T-Cell Lymphoma: A Randomized Controlled, Multicenter, Open-label Study in China

Li, Xin; Cui, Yingying; Sun, Zhenchang; Zhang, Lei; L, Li; Wang, Xinhua; Wu, Jingjing; Fu, Xiaorui; Ma, Wei; Zhang, Xudong; Chang, Yu; Nan, Feifei; Li, Wencai; Su, Liping; Wang, Jinghua; Hou, Xue; Zhang, Mingzhi

doi:10.1158/1078-0432.ccr-16-0153

Cited by 115 publications

(105 citation statements)

References 28 publications

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“…This survival benefit may be due to introducing rituximab. To date, gemcitabine-based combination chemotherapy has been demonstrated to be highly successful in improving the treatment outcome of T/NK-cell lymphoma (33)(34)(35). However, in the present study patients with T/NK-cell LAHS who were treated with gemcitabine did not exhibit survival advantage.…”

Section: T/nk-cell Lymphomacontrasting

confidence: 69%

“…L-asp/peg-based regimens were analyzed in the ENKL group and led to an improved prognosis. L-asp/peg-containing regimens have been indicated to be highly effective for patients with NK/T-cell lymphoma (35). The prior studies also demonstrated that the significant efficacy and safety profile of the peg-based regimen in the treatment of newly diagnosed and relapsed/refractory ENKL (35)(36)(37).…”

Section: T/nk-cell Lymphomamentioning

confidence: 99%

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Lymphoma associated hemophagocytic syndrome: A single‑center retrospective study

Chang

Cui

et al. 2018

Oncol Lett

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To improve the understanding of lymphoma associated hemophagocytic syndrome (LAHS) and find an effective treatment for this fatal disease, 57 patients with LAHS were retrospectively reviewed. The most common histopathological type was extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKL) (45.61%). Patients with B-cell LAHS were significantly older (P<0.001), and exhibited a higher triglyceride level (P=0.012), lower serum ferritin level (P=0.014) and lower plasma Epstein-Barr virus DNA (P<0.001) compared with patients with T/NK-cell LAHS. The median survival time of all patients was 43 days, and patients with B-cell (n=14) and T/NK-cell (n=43) LAHS had a median survival time of 55 and 40 days, respectively (P=0.797). Compared with patients who were treated based on HLH-2004 protocols combined with multidrug chemotherapy, those without chemotherapy had a reduced prognosis (P=0.002). The patients that underwent hematopoietic stem cell transplantation (HSCT) following chemotherapy had a significantly improved overall survival (OS) compared with patients that did not undergo HSCT (P=0.001). Patients with B-cell LAHS treated with rituximab (P=0.015) and patients with ENKL treated with L-asparaginase/pegaspargase (L-asp/peg) (P=0.009) had an improved prognosis compared with patients not treated with these drugs. In the T/NK-cell LAHS group, patients treated with chemotherapy containing gemcitabine did not exhibit an improved OS compared with those not treated with gemcitabine (P=0.326). Furthermore, multivariate analysis demonstrated that long diagnosis time and poor performance status were independent prognosis factors for all patients with LAHS. The present study indicated that survival time does not differ between patients with B-cell LAHS and patients with T/NK-cell LAHS. Early diagnosis and appropriate immunochemotherapy plus HSCT are essential to achieve improved outcomes. The outcome of patients with B-cell LAHS may be significantly improved following treatment with rituximab. L-asp/peg-containing regimens are promising treatments for patients with NK/T-cell LAHS.

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Section: T/nk-cell Lymphomacontrasting

confidence: 69%

Section: T/nk-cell Lymphomamentioning

confidence: 99%

Lymphoma associated hemophagocytic syndrome: A single‑center retrospective study

Chang

Cui

et al. 2018

Oncol Lett

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“…24 Recently, some studies have demonstrated the efficacy of l-ASP/peg-asparaginase-based chemotherapy in ENKTCL ( l-ASP/peg-asparaginase-based regimens have also demonstrated good efficacy in newly diagnosed advanced-stage NK/T-cell lymphoma, with a CR rate of 29%-71% and a 1-year OS rate of 45%-90%. 24,32,34 The P-GEMOX regimen was proven to be effective and well tolerated in newly diagnosed stage III/IV and relapsed/refractory ENKTCL in a retrospective study that included 35 patients. 13 In that study, the 3-year OS and PFS rates were 64.7% and 38.6%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and tolerance of GELOXD/P‐GEMOXD in newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma: A multicenter retrospective study

Zhong

et al. 2018

European J of Haematology

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“…Another L-asparaginase-containing regimen DDGP (dexamethasone, gemcitabine, cisplatinum, and pegaspargase) was compared with SMILE in a phase III randomized trial for untreated advanced-stage NK/T-cell lymphoma [74]. Twenty-one patients received DDGP, achieving ORR and CR rate of 95 and 71%.…”

Section: Introductionmentioning

confidence: 99%

The diagnosis and management of NK/T-cell lymphomas

2017

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Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignancy of putative NK-cell origin, with a minority deriving from the T-cell lineage. Pathologically, the malignancy occurs in two forms, extranodal NK/T-cell lymphoma, nasal type; and aggressive NK-cell leukaemia. Lymphoma occur most commonly (80%) in the nose and upper aerodigestive tract, less commonly (20%) in non-nasal areas (skin, gastrointestinal tract, testis, salivary gland), and rarely as disseminated disease with a leukemic phase. Genetic analysis showed mutations of genes involved in the JAK/STAT pathway, RNA assembly, epigenetic regulation, and tumor suppression. In initial clinical evaluation, positron emission tomography computed tomography, and quantification of plasma EBV DNA are mandatory as they are useful for response monitoring and prognostication. In stage I/II diseases, combined chemotherapy and radiotherapy (sequentially or concurrently) is the best approach. Conventional anthracycline-containing regimens are ineffective and should be replaced by non-anthracycline-containing regimens, preferably including L-asparaginase. Radiotherapy alone is associated with high systemic relapse rates and should be avoided. In stage III/IV diseases, non-anthracycline-regimens-containing L-asparaginase are the standard. In relapsed/refractory cases, blockade of the programmed death protein 1 has recently shown promising results with high response rates. In the era of effective non-anthracycline-containing regimens, autologous haematopoietic stem cell transplantation (HSCT) has not been shown to be beneficial. However, allogeneic HSCT may be considered for high-risk or advanced-stage patients in remission or relapsed/refractory patients responding to salvage therapy. Prognostic models taking into account presentation, interim, and end-of-treatment parameters are useful in triaging patients to different treatment strategies.

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DDGP versus SMILE in Newly Diagnosed Advanced Natural Killer/T-Cell Lymphoma: A Randomized Controlled, Multicenter, Open-label Study in China

Abstract: DDGP chemotherapy resulted in significant improvement in PFS, OS, and better tolerability compared with SMILE chemotherapy for newly diagnosed advanced NK/T-cell lymphoma patients. Clin Cancer Res; 22(21); 5223-8. ©2016 AACR.

Cited by 115 publications

References 28 publications

Lymphoma associated hemophagocytic syndrome: A single‑center retrospective study

Lymphoma associated hemophagocytic syndrome: A single‑center retrospective study

Efficacy and tolerance of GELOXD/P‐GEMOXD in newly diagnosed nasal‐type extranodal NK/T‐cell lymphoma: A multicenter retrospective study

The diagnosis and management of NK/T-cell lymphomas

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