Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma

CISL08-01 phase II study

Seok Jin Kim, Deok Hwan Yang, Jinseok Kim, Jae Yong Kwak, Hyeon Seok Eom, Dae Sik Hong, Jong Ho Won, Jae Hoon Lee, Dok Hyun Yoon, Jaeho Cho, Taek Keun Nam, Sang wook Lee, Yong Chan Ahn, Cheolwon Suh, Won Seog Kim

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Abstract

We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of l-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40–44 Gy of radiotherapy with weekly administration of 30 mg/m2 of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m2), ifosfamide (1,200 mg/m2), and dexamethasone (40 mg) from days 1 to 3, and l-asparaginase (4,000 IU/m2) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and l-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by l-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.

Original languageEnglish
Pages (from-to)1895-1901
Number of pages7
JournalAnnals of Hematology
Volume93
Issue number11
DOIs
Publication statusPublished - 2014 Jan 1

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Extranodal NK-T-Cell Lymphoma
Asparaginase
Chemoradiotherapy
Drug Therapy
Ifosfamide
Etoposide
Dexamethasone
Cisplatin
Disease-Free Survival
Disease Progression
Radiotherapy
Survival Rate
Recurrence
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hematology

Cite this

Kim, Seok Jin ; Yang, Deok Hwan ; Kim, Jinseok ; Kwak, Jae Yong ; Eom, Hyeon Seok ; Hong, Dae Sik ; Won, Jong Ho ; Lee, Jae Hoon ; Yoon, Dok Hyun ; Cho, Jaeho ; Nam, Taek Keun ; Lee, Sang wook ; Ahn, Yong Chan ; Suh, Cheolwon ; Kim, Won Seog. / Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma : CISL08-01 phase II study. In: Annals of Hematology. 2014 ; Vol. 93, No. 11. pp. 1895-1901.
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title = "Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study",
abstract = "We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of l-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40–44 Gy of radiotherapy with weekly administration of 30 mg/m2 of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m2), ifosfamide (1,200 mg/m2), and dexamethasone (40 mg) from days 1 to 3, and l-asparaginase (4,000 IU/m2) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 {\%} overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 {\%} final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and l-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 {\%}, respectively. In conclusion, CCRT followed by l-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.",
author = "Kim, {Seok Jin} and Yang, {Deok Hwan} and Jinseok Kim and Kwak, {Jae Yong} and Eom, {Hyeon Seok} and Hong, {Dae Sik} and Won, {Jong Ho} and Lee, {Jae Hoon} and Yoon, {Dok Hyun} and Jaeho Cho and Nam, {Taek Keun} and Lee, {Sang wook} and Ahn, {Yong Chan} and Cheolwon Suh and Kim, {Won Seog}",
year = "2014",
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Kim, SJ, Yang, DH, Kim, J, Kwak, JY, Eom, HS, Hong, DS, Won, JH, Lee, JH, Yoon, DH, Cho, J, Nam, TK, Lee, SW, Ahn, YC, Suh, C & Kim, WS 2014, 'Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma: CISL08-01 phase II study', Annals of Hematology, vol. 93, no. 11, pp. 1895-1901. https://doi.org/10.1007/s00277-014-2137-6

Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma : CISL08-01 phase II study. / Kim, Seok Jin; Yang, Deok Hwan; Kim, Jinseok; Kwak, Jae Yong; Eom, Hyeon Seok; Hong, Dae Sik; Won, Jong Ho; Lee, Jae Hoon; Yoon, Dok Hyun; Cho, Jaeho; Nam, Taek Keun; Lee, Sang wook; Ahn, Yong Chan; Suh, Cheolwon; Kim, Won Seog.

In: Annals of Hematology, Vol. 93, No. 11, 01.01.2014, p. 1895-1901.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Concurrent chemoradiotherapy followed by l-asparaginase-containing chemotherapy, VIDL, for localized nasal extranodal NK/T cell lymphoma

T2 - CISL08-01 phase II study

AU - Kim, Seok Jin

AU - Yang, Deok Hwan

AU - Kim, Jinseok

AU - Kwak, Jae Yong

AU - Eom, Hyeon Seok

AU - Hong, Dae Sik

AU - Won, Jong Ho

AU - Lee, Jae Hoon

AU - Yoon, Dok Hyun

AU - Cho, Jaeho

AU - Nam, Taek Keun

AU - Lee, Sang wook

AU - Ahn, Yong Chan

AU - Suh, Cheolwon

AU - Kim, Won Seog

PY - 2014/1/1

Y1 - 2014/1/1

N2 - We conducted a phase II trial of concurrent chemoradiotherapy (CCRT) followed by 2 cycles of l-asparaginase-containing chemotherapy for patients who were newly diagnosed with stages IE and IIE nasal extranodal NK/T cell lymphoma (ENKTL). CCRT consisted of 40–44 Gy of radiotherapy with weekly administration of 30 mg/m2 of cisplatin for 4 weeks. Two cycles of VIDL (etoposide (100 mg/m2), ifosfamide (1,200 mg/m2), and dexamethasone (40 mg) from days 1 to 3, and l-asparaginase (4,000 IU/m2) every other day from days 8 to 20) were administered sequentially. CCRT yielded a 90 % overall response rate without significant side effects in 30 patients, including 20 patients with complete response (CR); however, two patients showed distant disease progression. After CCRT, VIDL chemotherapy showed an 87 % final CR rate (26/30). Although grade III or IV hematologic toxicity was frequent during VIDL chemotherapy, no treatment-related mortality was observed, and l-asparaginase-associated toxicity was manageable. With a median follow-up of 44 months, 11 patients showed local (n = 4) and distant (n = 7) relapse or progression. The estimated 5-year progression-free and overall survival rates were 73 and 60 %, respectively. In conclusion, CCRT followed by l-asparaginase-containing chemotherapy is a feasible treatment for newly diagnosed stages IE/IIE nasal ENKTL.

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JO - Annals of Hematology

JF - Annals of Hematology

SN - 0939-5555

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