PEG-Asparaginase Based Multidrug Chemotherapy is Effective for Refractory Disseminated Extranodal NK/T-Cell Lymphoma With Leptomentigeal Involvement: A Clinical Case Report and Review of Literature

Abstract

Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is an Epstein-Barr virus (EBV)-associated lymphoid malignancy derived from natural killer or cytotoxic T-cells. While many patients with early stage ENKTL can achieve complete remission after radiochemotherapy, patients with advanced stage, relapsed or refractory ENKTL usually respond poorly to conventional treatment. We present a case of ENKTL which did not respond to regular radiochemotherapy. One month after treatment, the disease progressed with dissemination to the mesenteric lymph nodes as well as central nervous system (CNS). However, the disease was effectively controlled by the addition of pegylated asparaginase (PEG-asparaginase), dexamethasone, and methotrexate to the regiment. Our data suggest that PEG-asparaginase based multidrug chemotherapy is a promising strategy to treat refractory and disseminated ENKTL involving the CNS.




doi: http://dx.doi.org/10.4021/jh60w