Management of extranodal natural killer/T-cell lymphoma, nasal type

Ranjit Kumar Chaudhary, Vijaya R Bhatt, Julie Marie Vose

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Abstract Extranodal natural killer/T-cell lymphoma, nasal type (NKTL) is an uncommon aggressive subtype of non-Hodgkin lymphoma, which is significantly more common in East Asia and Latin America. Three-quarters of patients present with stage I/II disease, and half of patients have a low-risk International Prognostic Index score. Although additional factors including natural killer/T-cell lymphoma prognostic index and peripheral blood Epstein-Barr virus load influence the outcomes, the modality of treatment largely differs according to stage (based on nonrandomized studies). In early-stage disease, a combination of chemotherapy and involved-field radiotherapy (IFRT) appears to improve outcome compared with chemotherapy alone. Radiotherapy dose > 50 Gy, concurrent or sequential chemoradiation, and early use of IFRT results in better outcomes than doses < 50 Gy and delay in initiation of IFRT. In late-stage NKTL, chemotherapy alone is the mainstay of treatment. Compared with the CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) regimen, newer regimens containing L-asparaginase and gemcitabine result in better outcomes; however, toxicity might be an issue. Stem cell transplant has been used as salvage and consolidation therapy with some benefit, particularly in patients with advanced-stage disease in remission at the time of transplant; however, further confirmatory studies are needed. In the past decade, we have seen a significant growth in our understanding of the disease process and an increase in our armamentarium of effective therapeutics; however, further development of novel therapies and optimal selection of available therapy options via randomized trials are necessary to improve the outcomes of this aggressive lymphoma.

Original languageEnglish (US)
Article number536
Pages (from-to)245-252
Number of pages8
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number5
DOIs
StatePublished - May 1 2015

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Keywords

  • Epstein-Barr virus
  • Gemcitabine
  • Involved-field radiotherapy
  • L-asparaginase
  • Natural killer/T-cell lymphoma prognostic index

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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