Efficacy of a short sandwich protocol, methotrexate, gemcitabine, L‐asparaginase and dexamethasone chemotherapy combined with radiotherapy, in localised newly diagnosed NK/T‐cell lymphoma: A French retrospective study

Author:

Chaubard Sammara1,Marouf Amira2,Lavergne David1,Lemonnier François3,Rossignol Julien4,Clavert Aline5,Gressin Rémy6,Cartron Guillaume7,Waultier‐Rascalou Agathe8,Vargaftig Jacques9,Salles Gilles10,Bachy Emmanuel10,Ghesquières Hervé10ORCID,Tournilhac Olivier11ORCID,Chauchet Adrien12,Le Gouill Steven13,Damaj Gandhi14,Fornecker Luc‐Matthieu15ORCID,Sibon David4ORCID,Obéric Lucie16ORCID,Michot Jean‐Marie17ORCID,Gaulard Philippe18,Hermine Olivier24,Couronné Lucile219ORCID,Jaccard Arnaud1

Affiliation:

1. Hematology Department Limoges University Hospital Limoges France

2. Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM U1163, Imagine Institute Université Paris Cité Paris France

3. Hematology Department, Henri Mondor University Hospital, Assistance Publique des Hôpitaux de Paris, INSERM U955, Mondor Institute for Biomedical Research Paris‐Est Créteil University Créteil France

4. Hematology Department Necker Hospital, Assistance Publique des Hôpitaux de Paris Paris France

5. Hematology Department Angers University Hospital Angers France

6. Hematology Department Grenoble University Hospital Grenoble France

7. Hematology Department University Hospital Center UMR‐CNRS 5235 Montpellier France

8. Hematology Department Nîmes University Hospital Nîmes France

9. Hematology Department René Huguenin Hospital‐Curie Institute Saint‐Cloud France

10. Hematology Department Lyon‐Sud Hospital, University of Lyon Lyon France

11. Hematology Department Clermont University Hospital of Clermont‐Ferrand, Clermont Auvergne University Clermont‐Ferrand France

12. Hematology Department Jean Minjoz University Hospital Besançon France

13. Service d'Hématologie Clinique Hôtel‐Dieu, CHU Nantes, INSERM, CNRS, CRCINA Nantes, Université de Nantes, Faculté de Médecine Nantes France

14. Hematology Institute Caen University Hospital, Normandy University Caen France

15. Hematology Department Strasbourg University Hospital Strasbourg France

16. Hematology Department Toulouse‐Oncopole University Cancer Institute (IUCT‐O) Toulouse France

17. Gustave Roussy Institute, Département des Innovations Thérapeutiques et Essais Précoces Université Paris‐Saclay Villejuif France

18. Pathology Department, Henri Mondor University Hospital, Assistance Publique des Hôpitaux de Paris, INSERM U955, Mondor Institute for Biomedical Research Paris‐Est Créteil University Créteil France

19. Laboratory of Onco‐Hematology Necker Children's Hospital, Assistance Publique‐Hôpitaux de Paris (APHP) Paris France

Abstract

SummaryExtranodal NK/T‐cell lymphoma, nasal type is a rare and aggressive form of lymphoma, historically associated with poor prognosis. We report here the results of a retrospective multi‐centre study evaluating the efficacy of MGAD (methotrexate, gemcitabine, L‐asparaginase and dexamethasone) regimen (two cycles) combined with ‘sandwich’ radiotherapy in 35 patients with localised newly diagnosed extranodal NK/T‐cell lymphoma. Thirty‐two patients (91%) reached complete remission. With a long median follow‐up of 59.6 months, progression‐free and overall survival at 2 and 5 years were 71%, 80% and 53%, 73%, respectively. Around one third of the patients experienced relapse within a median time of 14.5 months. Side‐effects were manageable with grades 3–4 cytopenias, mucositis and infection in 50%, 24% and 21% of the cases, respectively. Monitoring of asparaginase activity was performed in 13 patients and showed inactivation of the drug in seven (54%) patients. Our results indicate that a short therapy by sandwich MGAD chemoradiotherapy is a tolerable and effective treatment option in localised newly diagnosed extranodal NK/T‐cell lymphoma patients.

Publisher

Wiley

Subject

Hematology

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