High-dose chemotherapy with autologous stem cell transplantation in extranodal NK/T-cell lymphoma: a retrospective comparison with non-transplantation cases

Kim, H. J.; Bang, Soo Mee; Lee, J.; Kwon, Hyuk‐Chan; Suh, Cheolwon; Lee, J. H.; Ryoo, Baek Yeol; Park, Y. H.; Kwon, Jieun; Oh, Sung Yong; Lee, H. R.; Kim, K.; Jung, Chul Won; Park, K.; Kim, W. S.

doi:10.1038/sj.bmt.1705349

Cited by 63 publications

(60 citation statements)

References 24 publications

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“…However, it must be pointed out that there were only three patients with a CR showing durable responses. The high proportion of patients who progressed after achieving an initial response to 3 cycles of chemotherapy reflects the aggressive nature of advanced-stage ENKTL and suggests that more intensive consolidative treatment such as autologous or allogenenic hematopoietic stem cell transplantation may be appropriate for those transplant eligible CR patients with a curative intent [15][16][17]. Attempts to improve outcome in patients with advanced-stage ENKTL in remission have included studies of high-dose therapy (HDT) supported by autologous stem cell transplantation (ASCT), allogeneic hematopoietic stem cell transplantation (HSCT) and novel treatment modalities.…”

Section: Treatment-related Toxicitymentioning

confidence: 99%

Retrospective Study of Pegaspargase, Gemicitabine, Oxaliplatin and Dexamethasone (Peg-GemOD) as a First-Line Therapy for Advanced-Stage Extranodal NK/T Cell Lymphoma

Yao

Tang

Zhuang

et al. 2016

Indian J Hematol Blood Transfus

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This study was conducted to retrospectively investigate the efficacy and safety of pegaspargase, gemicitabine, oxaliplatin and dexamethasone (PegGemOD) combination chemotherapy as a first-line therapy for advanced-stage extranodal NK/T cell lymphoma (ENKTL). Eighteen patients with newly diagnosed stage III/IV ENKTL were subjected to 3-6 cycles of PegGemOD chemotherapy. After 3 cycles of therapy, the overall response rate was 67 % (12/18) with a complete response rate of 28 % (5/18) and a partial response rate of 39 % (7/18). The median overall survival (OS) and progression-free survival (PFS) time were 10 and 8.5 months respectively. For those responders, the median OS and PFS time were significantly better than those of non-responders (median OS, 15 vs. 10 months; P = 0.001 and median PFS, 15 vs. 7 months; P = 0.001). Furthermore, patients with low plasma EBV-DNA levels after induction chemotherapy had a remarkably longer OS and PFS time. The toxicity of Peg-GemOD regimen was acceptable.

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Section: Treatment-related Toxicitymentioning

confidence: 99%

Retrospective Study of Pegaspargase, Gemicitabine, Oxaliplatin and Dexamethasone (Peg-GemOD) as a First-Line Therapy for Advanced-Stage Extranodal NK/T Cell Lymphoma

Yao

Tang

Zhuang

et al. 2016

Indian J Hematol Blood Transfus

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“…It is crucial to attain CR in patients with aggressive lymphoma. Several studies demonstrated that a CR with induction chemotherapy followed by radiotherapy may prolong survival in ENKTCL cases (24)(25)(26). Therefore, efforts have been focusing on designing novel chemotherapeutic regimens, effective in achieving a high CR rate.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of gemcitabine combined with oxaliplatin, L-asparaginase and dexamethasone in patients with newly-diagnosed extranodal NK/T-cell lymphoma

Guo

Liu

Wang

et al. 2014

Molecular and Clinical Oncology

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Abstract. There is currently no standard first-line regimen for patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTCL). In this study, we investigated the efficacy and toxicity of gemcitabine (GEM) combined with oxaliplatin (L-OHP), L-asparaginase (L-ASP) and dexamethasone (DXM) (GOLD regimen) as a systemic treatment scheme for newly-diagnosed ENKTCL cases. A total of 55 patients were The response rate, survival rate and treatment toxicity were analyzed. The overall response rate was 91% (48/55) with a complete response in 62% (34/55) and a partial response in 29% (15/55) of the patients. For all patients, the 1-, 2-and 3-year progression-free survival (PFS) rate was 86, 64 and 57% and the overall survival (OS) 91, 80 and 74%, respectively. The 1-year PFS in patients with stage I̸II vs. those with III/IV disease was 87 vs. 66% (P<0.001) and the 1-year OS was 98 vs. 75%, respectively (P<0.001). No chemotherapy-related mortality or severe complications were recorded. In conclusion, the GOLD regimen was found to be highly effective and safe for the treatment of patients with newly-diagnosed ENKTCL.

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“…This corresponds to a median PFS of 8.2 months (95% CI 0.36-16.04) and median OS of 45.1 months (95% CI 0.00-100.28) and seems similar to previous reports. 9,11 Response assessment before ASCT should be noted in patients with ENKTL, because previous studies have reported that disease status at transplantation was the most important prognostic factor Figure 3. Kaplan-Meier curves for (a) PFS and (b) overall survival of patients undergoing either upfront ASCT or salvage ASCT.…”

Section: Discussionmentioning

confidence: 99%

“…However, previous studies have failed to clearly determine the efficacy of ASCT, because most of them were retrospective analyses with small sample sizes, and the enrolled patient populations were very heterogeneous, including various transplantation settings. [7][8][9][10][11] Moreover, although previous data showed that disease status at the time of ASCT was the most important prognostic factor for survival and relapse-free survival, 9,11 the optimal response assessment with respect to existing computed tomography (CT) scans, positron emission tomography/computed tomography (PET/CT) findings, and EBV DNA in blood has not yet been evaluated in ENKTL. Recently, our group suggested that post-treatment Deauville score (DS) based on PET/CT scan combined with the status of circulating EBV DNA at the end of treatment could predict the risk of treatment failure in patients with ENKTL.…”

Section: Introductionmentioning

confidence: 99%

Prognostic relevance of pretransplant Deauville score on PET-CT and presence of EBV DNA in patients who underwent autologous stem cell transplantation for ENKTL

Lim

et al. 2016

Bone Marrow Transplant

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High-dose chemotherapy and autologous stem cell transplantation (ASCT) for extranodal natural killer/T-cell lymphoma (ENKTL) is a reasonable option for a subset of patients. The impact of response status, according to positron emission tomography/computed tomography (PET/CT) results and/or presence of circulating EBV DNA prior to ASCT, has not yet been established. We analyzed 27 ENKTL patients with pre-ASCT circulating EBV DNA who had undergone pre-ASCT PET/CT between 2009 and 2014. We classified patients into two groups based on the result of pretransplantation assessment: a favorable risk group (pretransplant five-point Deauville score (DS) of 1-2 based on PET/CT and no detectable EBV DNA) and an unfavorable risk group (DS 1-2 with detectable EBV DNA, DS 3-5 with or without detectable EBV DNA). After a median follow-up of 37 months, overall survival and PFS were significantly different between the two groups (median OS: not reached for favorable risk group vs 7.0 months for unfavorable risk group, P = 0.017; median PFS: 16.0 vs 5.0 months, P = 0.019). Multivariate analysis revealed that pre-ASCT DS and EBV DNA was the only independent prognostic factor considering stage, IPI and NKPI. Precise assessment of the status of disease before transplantation may provide more benefit from ASCT to ENKTL patients.Bone Marrow Transplantation (2016) 51, 807-812; doi:10.1038/bmt.2016.6; published online 8 February 2016 INTRODUCTIONExtranodal natural killer/T-cell lymphoma (ENKTL) is a rare and distinct subtype of non-Hodgkin lymphoma (NHL), which is characterized by clinically aggressive behavior leading to poor survival among all T-cell lymphoma subtypes. 1 Concurrent chemoradiotherapy (CCRT) followed by chemotherapy has shown promising results with manageable toxicities for localized disease, 2,3 and the application of nonanthracycline-based chemotherapy incorporating L-asparaginase has improved survival outcome of advanced, relapsed or refractory ENKTL patients. [4][5][6] However, treatment failure still occurs frequently, and thus the unmet need persists for additional therapies to improve outcomes for patients with ENKTL. Accordingly, highdose chemotherapy with autologous stem cell transplantation (ASCT) has been evaluated as a consolidation therapy for ENKTL. However, previous studies have failed to clearly determine the efficacy of ASCT, because most of them were retrospective analyses with small sample sizes, and the enrolled patient populations were very heterogeneous, including various transplantation settings. 7-11 Moreover, although previous data showed that disease status at the time of ASCT was the most important prognostic factor for survival and relapse-free survival, 9,11 the optimal response assessment with respect to existing computed tomography (CT) scans, positron emission tomography/computed tomography (PET/CT) findings, and EBV

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High-dose chemotherapy with autologous stem cell transplantation in extranodal NK/T-cell lymphoma: a retrospective comparison with non-transplantation cases

Cited by 63 publications

References 24 publications

Retrospective Study of Pegaspargase, Gemicitabine, Oxaliplatin and Dexamethasone (Peg-GemOD) as a First-Line Therapy for Advanced-Stage Extranodal NK/T Cell Lymphoma

Retrospective Study of Pegaspargase, Gemicitabine, Oxaliplatin and Dexamethasone (Peg-GemOD) as a First-Line Therapy for Advanced-Stage Extranodal NK/T Cell Lymphoma

Efficacy of gemcitabine combined with oxaliplatin, L-asparaginase and dexamethasone in patients with newly-diagnosed extranodal NK/T-cell lymphoma

Prognostic relevance of pretransplant Deauville score on PET-CT and presence of EBV DNA in patients who underwent autologous stem cell transplantation for ENKTL

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