AspaMetDex方案治疗早期鼻腔NK/T细胞淋巴瘤的临床研究

Clinical Study of AspaM etD ex Regimen for Treatment of Early Nasal NK/T-cell Lymphoma

目的：观察AspaMetDex方案治疗早期鼻腔NK/T细胞淋巴瘤的临床疗效及安全性。方法：分析2012年9月至2013年8月我院肿瘤中心收治的早期鼻腔NK/T细胞淋巴瘤15例,AspaMetDex治疗,第1天：培门冬酶2500 IU/m2,甲氨蝶呤3 g/m2;第1~4天：地塞米松40 mg/d,每21天为1个周期,化疗2周期后评价疗效及不良反应。结果：所有患者均完成2周期化疗,完全缓解8例（8/15）,部分缓解5例（5/15）,有效率为86.7%。严重不良反应发生率较低,仅2例（13.3%）患者出现Ⅲ级以上白细胞减少,10例（66.7%）出现白蛋白降低,其他不良反应包括恶心、呕吐,肝功能异常,无1例患者出现严重过敏反应、急性胰腺炎及血栓形成。中位随访时间30月（6~42月）,3年总生存率：86.67%,无疾病生存率为78.57%。结论：AspaMetDex方案治疗早期鼻腔NK/T细胞淋巴瘤疗效好,且不良反应发生率较低。

Objective To evaluate the efficacy and safety of AspaMetDex （ pegaspargase, methotrexate, dexamethasone） regi- men in the treatment of early nasal NK/T-celt lymphoma.Methoda From September 2013 to August 2014,fifteen patients were diagnosed as early nasal NK/T-cell lymphoma in our hospital. All patients received the AspaMetDex regimen （pegaspargase 2500 IU/m2 and methotrexate 3 g/m2 at day 1 ,dexamethasone 40 mg/d from day 1 to day 4） ,every three weeks as one course.The efficacy and toxicity of the regimen were evaluated after two courses.Results All the patients had accom- plished two courses,in which 8 achieved complete remission,5 had partial remission,the effective rate was 86.7%.The inci- dence of severe adverse reactions was low, myelosuppression over grade 11I had happened only in 2 cases, hypoalbuminemia in 10 cases, and the other adverse reactions included nausea, vomit and liver dysfunction, but no anaphylaxis, acute pancrea- titis and thrombosis had happened.The median follow-up time was 30 months（range from 6 to 42 months）.The 3-year overall survival（OS） and progression-free survival（PFS） were 86,67% and 78.57%.Conclusion AspaMetDex regimen showed high efficacy on the initial treatment of nasal NK/T-cell lymphoma patients ,but the incidence of adverse reactions was still high. Key words t Pegaspargase; Methotrexate; NK/T-ceU lymphoma