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. 2023 May;201(4):673-681.
doi: 10.1111/bjh.18689. Epub 2023 Feb 17.

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

Sammara Chaubard  1 , Amira Marouf  2 , David Lavergne  1 , François Lemonnier  3 , Julien Rossignol  4 , Aline Clavert  5 , Rémy Gressin  6 , Guillaume Cartron  7 , Agathe Waultier-Rascalou  8 , Jacques Vargaftig  9 , Gilles Salles  10 , Emmanuel Bachy  10 , Hervé Ghesquières  10 , Olivier Tournilhac  11 , Adrien Chauchet  12 , Steven Le Gouill  13 , Gandhi Damaj  14 , Luc-Matthieu Fornecker  15 , David Sibon  4 , Lucie Obéric  16 , Jean-Marie Michot  17 , Philippe Gaulard  18 , Olivier Hermine  2   4 , Lucile Couronné  2   19 , Arnaud Jaccard  1
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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

Sammara Chaubard et al. Br J Haematol. 2023 May.

Abstract

Extranodal 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.

Keywords: NK-T cell lymphoma; asparaginase activity; non-Hodgkin lymphoma; radio-chemotherapy.

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References

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