Management of advanced NK/T-cell lymphoma

Curr Hematol Malig Rep. 2014 Sep;9(3):233-42. doi: 10.1007/s11899-014-0216-3.

Abstract

NK/T-cell lymphomas are aggressive malignancies, and the outlook is poor when conventional anthracycline-containing regimens designed for B-cell lymphomas are used. With the advent of L-asparaginase-containing regimens, treatment outcome has significantly improved. L-asparaginase-containing regimens are now considered the standard in the management of NK/T-cell lymphomas. In advanced diseases, however, outcome remains unsatisfactory, with durable remission achieved in only about 50% of cases. Stratification of patients with advanced NK/T-cell lymphomas is needed, so that poor-risk patients can be given additional therapy to improve outcome. Conventional presentation parameters are untested and appear inadequate for prognostication when L-asparaginase-containing regimens are used. Recent evidence suggests that dynamic factors during treatment and interim assessment, including Epstein-Barr virus (EBV) DNA quantification and positron emission tomography computed tomography findings, are more useful in patient stratification. The role of high-dose chemotherapy and haematopoietic stem cell transplantation requires evaluation in an overall risk-adapted treatment algorithm.

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Asparaginase / therapeutic use*
  • Epstein-Barr Virus Infections / blood
  • Hematopoietic Stem Cell Transplantation / methods*
  • Herpesvirus 4, Human / isolation & purification
  • Humans
  • Lymphoma, Extranodal NK-T-Cell / blood
  • Lymphoma, Extranodal NK-T-Cell / pathology
  • Lymphoma, Extranodal NK-T-Cell / therapy*
  • Lymphoma, Extranodal NK-T-Cell / virology
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Prognosis
  • Treatment Outcome
  • Viral Load

Substances

  • Antineoplastic Agents
  • Asparaginase