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Retrospective study of modified SMILE chemotherapy for advanced-stage, relapsed, or refractory extranodal natural killer (NK)/T cell lymphoma, nasal type

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Abstract

Extranodal natural killer/T cell lymphomas, nasal type (ENKLs), which are a group of non-Hodgkin lymphomas with poor prognoses, are much more common in China than in Western countries. Here, we retrospectively assessed the impact of two treatment regimens on clinical response and survival among 42 ENKL patients. All patients were diagnosed with stage IV, relapsed, or refractory ENKL. Twenty patients received modified SMILE (consisting of L-asparaginase, methotrexate, ifosphamide, etoposide, and dexamethasone) chemotherapy, and 22 control patients received CHOP (consisting of cyclophosphamide, doxorubicin, vincristine, and prednisone) treatment. Higher complete response (CR) and overall response rates (ORR) (CR 45.0 vs. 13 %, ORR 70 vs. 36 %) were observed among the patients treated with the modified SMILE regimen (Fisher’s exact = 0.040, Pearson χ2 P = 0.030). Similarly, a higher ORR rate was observed among Epstein-Barr virus-positive patients (ORR 50.0 vs. 18.0 %, Fisher’s exact = 0.049). The treatment group was also significantly associated with longer overall survival (OS) and progression-free survival (PFS) (Log-rank, P = 0.0341, P = 0.0142, respectively), but OS did not seem to be longer. Treatment-related toxicity was monitored in all patients throughout the protocol. There were no significant differences in the incidence of hematological and non-hematological toxicities between the two groups (P < 0.05), with the exception of peripheral neuropathy (treatment = 0 control = 5, Fisher’s exact = 0.049).

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Acknowledgments

We would like to thank the patients and clinical staff of our center for their assistance in this study. We are particularly grateful to Dr. Liu Hong for her critical review of the protocol and manuscript. This study was supported in part by the Affiliated Hospital of Nantong University. We also acknowledge our colleagues at Nantong Cancer Hospital, who also contributed to this research.

Conflict of interest

No potential conflict of interest was disclosed by any of the authors. No author received honoraria from this research.

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Authors and Affiliations

  1. Hematology Department, Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China

    Li Yang, Hong Liu, Xin-feng Wang, Hong-ming Huang, Wen-yu Shi & Sheng-hua Jiang

  2. Lymphoma Center, Nantong Cancer Hospital, Nantong, 226000, Jiangsu, China

    Xiao-hong Xu

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  1. Li Yang
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  2. Hong Liu
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  3. Xiao-hong Xu
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  4. Xin-feng Wang
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Correspondence to Xiao-hong Xu or Sheng-hua Jiang.

Additional information

Yang Li and Liu Hong have contributed equally to this study and should be considered as joint first authors.

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Yang, L., Liu, H., Xu, Xh. et al. Retrospective study of modified SMILE chemotherapy for advanced-stage, relapsed, or refractory extranodal natural killer (NK)/T cell lymphoma, nasal type. Med Oncol 30, 720 (2013). https://doi.org/10.1007/s12032-013-0720-7

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