Title |
Ifosfamide, methotrexate, etoposide, and prednisolone (IMEP) plus l-asparaginase as a first-line therapy improves outcomes in stage III/IV NK/T cell-lymphoma, nasal type (NTCL)
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Published in |
Annals of Hematology, October 2014
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DOI | 10.1007/s00277-014-2228-4 |
Pubmed ID | |
Authors |
Miso Kim, Tae Min Kim, Ki Hwan Kim, Bhumsuk Keam, Se-Hoon Lee, Dong-Wan Kim, Jong Seok Lee, Yoon Kyung Jeon, Chul Woo Kim, Dae Seog Heo |
Abstract |
The prognosis of patients with stage III/IV NK/T-cell lymphoma (NTCL) is extremely poor. Although L-asparaginase (L-asp) is effective for NTCL, its significance has not been clearly demonstrated. In addition, there are few studies comparing treatment outcomes in stage III/IV NTCL. This study evaluated the efficacy of L-asp-based chemotherapy and prognostic factors in stage III/IV NTCL. Seventy patients with newly diagnosed stage III/IV NTCL were enrolled between January 2000 and February 2013. Patients received ifosfamide, etoposide, methotrexate, and prednisolone (IMEP) plus L-asp (N = 22) or combination chemotherapy without L-asp (N = 48) as a first-line treatment. Clinical prognostic factors, treatment outcomes, and prognostic scores were compared between the groups. After a median follow-up period of 12.8 months (range, 1.1-186.6 months), median overall survival (OS) and progression-free survival (PFS) were 11.3 and 5.6 months, respectively. Treatment outcomes were superior in patients treated with IMEP plus L-asp compared to those treated with chemotherapy without L-asp (overall response rate, 90.0 vs. 34.8 %, P < 0.001; complete remission rate, 65.0 vs. 21.7 %, P = 0.001). The OS and PFS were significantly higher for the IMEP plus L-asp group compared with the chemotherapy without L-asp group. In a multivariate analysis, the use of chemotherapy without L-asp was an independent predictor of reduced OS (hazards ratio (HR) = 2.18, 95 % confidence interval (CI) 1.08-4.40; P = 0.030) and PFS (HR = 2.29, 95 % CI 1.22-4.29; P = 0.010). IMEP plus L-asp is active against stage III/IV NTCL, and it is an independent predictor of improved survival. |
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Country | Count | As % |
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Unknown | 24 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 4 | 17% |
Professor > Associate Professor | 3 | 13% |
Student > Master | 3 | 13% |
Other | 2 | 8% |
Student > Postgraduate | 2 | 8% |
Other | 3 | 13% |
Unknown | 7 | 29% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 9 | 38% |
Biochemistry, Genetics and Molecular Biology | 4 | 17% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
Agricultural and Biological Sciences | 1 | 4% |
Neuroscience | 1 | 4% |
Other | 0 | 0% |
Unknown | 8 | 33% |