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Annals of Oncology Advance Access originally published online on August 13, 2008
Annals of Oncology 2009 20(1):110-116; doi:10.1093/annonc/mdn542
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

hematologic malignancies

L-Asparaginase-based treatment of 15 western patients with extranodal NK/T-cell lymphoma and leukemia and a review of the literature

A. Jaccard1,*, B. Petit2, S. Girault1, F. Suarez3, R. Gressin4, J.-M. Zini5, V. Coiteux6, C. Larroche7, A. Devidas8, C. Thiéblemont9, P. Gaulard10, B. Marin11, N. Gachard12, D. Bordessoule1 and O. Hermine3

1 Department of Hematology
2 Department of Pathology, Centre Hospitalier Universitaire, Limoges, France
3 Department of Hematology, Hôpital Necker, APHP and Université Paris Descartes, Paris
4 Department of Hematology, Centre Hospitalier Universitaire, Grenoble
5 Department of Hematology, Hôpital Lariboisière, APHP, Paris
6 Department of Hematology, Centre Hospitalier Universitaire, Lille
7 Department of Internal Medicine, Hôpital Avicenne, APHP, Bobigny
8 Department of Pathology, Centre Hospitalier du Sud Francilien, Evry
9 Department of Hematology, Hôpital Saint-Louis, Paris
10 Department of Pathology, and Inserm Unité 617, Hôpital Henri Mondor, AP-HP, Créteil
11 Biostatistics and Clinical Research Unit
12 Department of Hematology, Centre Hospitalier Universitaire, Limoges, France

* Correspondence to: Dr A. Jaccard, Service d'Hématologie et de Thérapie Cellulaire, 1 av ML-King, CHU Limoges, France. Tel: +33-5-55056651, Fax: +33-5-55056649; E-mail: arnaud.jaccard{at}chu-limoges.fr

Background: Extranodal natural killer (NK)/T-cell lymphoma, nasal type, and aggressive NK-cell leukemia are highly aggressive diseases with a poor outcome.

Patients and methods: We report a multicentric French retrospective study of 15 patients with relapsed, refractory, or disseminated disease, treated with L-asparaginase-containing regimens in seven French centers. Thirteen patients were in relapse and/or refractory and 10 patients were at stage IV.

Results: All but two of the patients had an objective response to L-asparaginase-based treatment. Seven patients reached complete remission and only two relapsed.

Conclusion: These data, although retrospective, confirm the excellent activity of L-asparaginase-containing regimens in refractory extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia. Therefore, L-asparaginase-based regimen should be considered as a salvage treatment, especially for patients with disseminated disease. First-line L-asparaginase combination therapy for extranodal NK/T-cell lymphoma and aggressive NK-cell leukemia should be tested in prospective trials.

Key words: L-asparaginase, NK/T-cell lymphoma

Received for publication July 2, 2008. Accepted for publication July 4, 2008.


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