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Effectiveness of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of relapsed/refractory extranodal NK/T cell lymphoma: a retrospective study of 17 patients

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Abstract

The prognosis of extranodal nature killer (NK)/T cell lymphoma (ENKL) is dismal because of its aggressive course and multidrug resistance. Currently, for patients with relapsed/refractory ENKL, l-asparaginase-based regimens such as l-asparaginase, ifosfamide, methotrexate, etoposide, and dexamethasone (SMILE) or l-asparaginase, methotrexate, and dexamethasone (AspaMetDex) are recommended. We retrospectively investigated the efficacy and safety of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of 17 relapsed/refractory ENKL patients. Clinical data from these patients were collected and analyzed. The primary end point was overall response rate (ORR). All patients were subjected to 2 to 6 cycles of DDGP chemotherapy, and the median number of cycles of DDGP regimen administrated was four. The ORR was 88.2 % (15/17), with nine patients (52.9 %) achieved complete response (CR) and six patients (35.3 %) achieved partial response (PR). The median follow-up time was 17 months (range 2–28 months). The 1-year overall survival (OS) rate and 1-year progression-free survival (PFS) were 82.4 and 64.7 %, respectively. For those CR responders, the median PFS was 17 months. Grade 3/4 neutropenia occurred in nine patients (52.9 %) and grade 3/4 thrombocytopenia occurred in six patients (35.3 %). DDGP combination chemotherapy produces favorable outcomes in relapsed/refractory ENKL, and more attention should be paid to treatment-related myelosuppression. Further prospective trials are expected to define the efficacy.

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Acknowledgments

This work was supported by the National Natural Science Foundation of China [grant number 81172118].

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450052, China

    Zhiyuan Zhou, Xiang Li, Xin Li, Lei Zhang, Ling Li, Xinhua Wang, Wang Ma, Xiaorui Fu, Jingjing Wu, Zhenchang Sun, Xudong Zhang, Zhaoming Li, Jiaqin Yan, Yu Chang, Lisha Lu, Beibei Qin, Xiaoli Li & Mingzhi Zhang

  2. Institute of Clinical Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Zhiyuan Zhou, Xudong Zhang, Lisha Lu, Beibei Qin, Xiaoli Li & Jianguo Wen

  3. Outpatient Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Changying Chen

  4. Lymphoma Diagnosis and Treatment Center of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China

    Zhiyuan Zhou, Xin Li, Lei Zhang, Ling Li, Xinhua Wang, Wang Ma, Xiaorui Fu, Jingjing Wu, Zhenchang Sun, Xudong Zhang, Zhaoming Li, Jiaqin Yan, Yu Chang, Lisha Lu, Beibei Qin, Xiaoli Li & Mingzhi Zhang

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  1. Zhiyuan Zhou
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  2. Xiang Li
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Correspondence to Mingzhi Zhang.

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Zhou, Z., Li, X., Chen, C. et al. Effectiveness of gemcitabine, pegaspargase, cisplatin, and dexamethasone (DDGP) combination chemotherapy in the treatment of relapsed/refractory extranodal NK/T cell lymphoma: a retrospective study of 17 patients. Ann Hematol 93, 1889–1894 (2014). https://doi.org/10.1007/s00277-014-2136-7

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  • DOI: https://doi.org/10.1007/s00277-014-2136-7

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