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- Title
Comparison of Native Escherichia coli L-Asparaginase versus Pegylated Asparaginase, in Combination with Ifosfamide, Methotrexate, Etoposide, and Prednisolone, in Extranodal NK/T-Cell Lymphoma, Nasal Type.
- Authors
Hyun Jee Kim; Chan-Young Ock; Tae Min Kim; Sung Hee Lee; Ju-Yeun Lee; Sun hoi Jung; Yoon Sook Cho; Miso Kim; Bhumsuk Keam; Dong-Wan Kim; Il Han Kim; Dae Seog Heo
- Abstract
Purpose The aim of this study was to compare asparaginase-related toxicities in two asparaginase preparations, namely native Escherichia coli L-asparaginase (L-ASP) and pegylated asparaginase (PEG-ASP) in combination with ifosfamide, methotrexate, etoposide, and prednisolone (IMEP) in natural killer (NK)/T-cell lymphoma (NTCL). Materials and Methods A total of 41 NTCL patients who received IMEP plus native E. coli L-ASP or PEG-ASP at Seoul National University Hospital were included in this study between January 2013 and March 2016. IMEP/ASP treatment consisted of ifosfamide, methotrexate, etoposide, plus native E. coli L-ASP (6,000 IU/m² on days 1, 3, 5, 7, 9, and 11) or PEG-ASP (2,500 IU/m² on day 1) every 3 weeks. ASP-related toxicities, toxicity patterns, length of hospital stay, and clinical outcomes were compared between the different treatment groups. Results The frequency of ASP-related toxicities was similar between the IMEP plus native E. coli L-ASP group and the PEG-ASP group apart from hypofibrinogenemia (native E. coli L-ASP vs. PEG-ASP group, 86.4% vs. 36.8%; p=0.001). Although post-treatment transaminase and albumin levels were significantly high and low, respectively, hepatotoxicity gradients before and after treatment did not differ significantly between the groups. Since PEG-ASP was given at an outpatient clinic in some patients, length of hospital stay was significantly shorter in the IMEP plus PEG-ASP group (median, 4.0 vs. 6.0 days; p=0.002). A favorable tendency of clinical outcomes was observed in NTCL patients treated with IMEP plus PEG-ASP (complete remission rate, 73.7% vs. 45.5%; p=0.067). Conclusion IMEP plus PEG-ASP showed similar ASP-related toxicities, shorter length of hospital stay, and a trend towards improved clinical outcomes compared with IMEP plus native E. coli L-ASP in NTCL.
- Subjects
ASPARAGINASE; LYMPHOMA treatment; ESCHERICHIA coli; ALBUMINS; HEPATOTOXICOLOGY; CANCER chemotherapy; EXTRANODAL NK-T-cell lymphoma
- Publication
Cancer Research & Treatment, 2018, Vol 50, Issue 3, p670
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2017.051