Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study.

Details

Serval ID
serval:BIB_2A17F8675253
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relapsing extranodal NK/T-cell lymphoma, a phase 2 study.
Journal
Blood
Author(s)
Jaccard A., Gachard N., Marin B., Rogez S., Audrain M., Suarez F., Tilly H., Morschhauser F., Thieblemont C., Ysebaert L., Devidas A., Petit B., de Leval L., Gaulard P., Feuillard J., Bordessoule D., Hermine O., GELA 
Working group(s)
GOELAMS Intergroup
Contributor(s)
GELA , Galicier L., Brice P., Golfier JB., Gisselbrecht C., Joly B., Fitoussi O., Coppo P., Corront B., Cumin I., Rossi JF., Coiteux V., Lenain P., Laurent G., Recher C., Hunault M., Milpied N., Bouabdallah K., Legay T., Girault S., Turlure P., Dmytruck N., Moreau S., Gourin MP., Touati M., Remenieras L.
ISSN
1528-0020 (Electronic)
ISSN-L
0006-4971
Publication state
Published
Issued date
2011
Volume
117
Number
6
Pages
1834-1839
Language
english
Notes
Publication types: Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Extranodal NK/T-cell lymphoma, nasal type, is a rare and highly aggressive disease with a grim prognosis. No therapeutic strategy is currently identified in relapsing patients. We report the results of a French prospective phase II trial of an L-asparaginase-containing regimen in 19 patients with relapsed or refractory disease treated in 13 centers. Eleven patients were in relapse and 8 patients were refractory to their first line of treatment. L-Asparaginase-based treatment yielded objective responses in 14 of the 18 evaluable patients after 3 cycles. Eleven patients entered complete remission (61%), and only 4 of them relapsed. The median overall survival time was 1 year, with a median response duration of 12 months. The main adverse events were hepatitis, cytopenia, and allergy. The absence of antiasparaginase antibodies and the disappearance of Epstein-Barr virus serum DNA were significantly associated with a better outcome. These data confirm the excellent activity of L-asparaginase-containing regimens in extranodal NK/T-cell lymphoma. L-Asparaginase-based treatment should thus be considered for salvage therapy, especially in patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma warrants evaluation in prospective trials. This trial is registered at www.clinicaltrials.gov as #NCT00283985.
Keywords
Aged, Antibodies/blood, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Asparaginase/administration & dosage, Asparaginase/immunology, DNA, Viral/blood, Dexamethasone/administration & dosage, Disease-Free Survival, Female, France, Herpesvirus 4, Human/isolation & purification, Humans, Kaplan-Meier Estimate, Lymphoma, Extranodal NK-T-Cell/drug therapy, Lymphoma, Extranodal NK-T-Cell/immunology, Male, Methotrexate/administration & dosage, Middle Aged, Prognosis, Prospective Studies, Recurrence, Remission Induction, Salvage Therapy
Pubmed
Web of science
Open Access
Yes
Create date
15/03/2011 14:38
Last modification date
20/08/2019 13:09
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