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, Jin Seok 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

All Science Journal Classification (ASJC) codes

  • Hematology

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    Kim, S. J., Yang, D. H., Kim, J. S., Kwak, J. Y., Eom, H. S., Hong, D. S., Won, J. H., Lee, J. H., Yoon, D. H., Cho, J., Nam, T. K., Lee, S. W., Ahn, Y. C., Suh, C., & Kim, W. S. (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, 93(11), 1895-1901. https://doi.org/10.1007/s00277-014-2137-6