Treatment of advanced extranodal NK/T cell lymphoma, nasal-type and aggressive NK-cell leukemia
Treatment of advanced extranodal NK/T cell lymphoma, nasal-type and aggressive NK-cell leukemia
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DOI：
10.1007/s12185-010-0726-2
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发表时间：
2010-12-01
影响因子：
2.1
通讯作者：
Suzuki, Ritsuro
中科院分区：
文献类型：
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作者：
Suzuki, Ritsuro
晚期鼻型结外 NK/T 细胞淋巴瘤 (ENKL) 和侵袭性 NK 细胞白血病 (ANKL) 是高度侵袭性肿瘤，临床结果不佳。众所周知，ENKL或ANKL肿瘤细胞上表达有P-糖蛋白，它是MDR1基因的产物，与多药耐药相关。这是含蒽环类药物的恶性淋巴瘤的常规化疗方案无效的主要原因。然而，最近的研究发现，包括L-天冬酰胺酶、甲氨蝶呤和烷化剂在内的几种药物对这些肿瘤显示出优异的效果。 SMILE（类固醇、甲氨蝶呤、异环磷酰胺、L-天冬酰胺酶和依托泊苷）方案是治疗晚期或复发/难治性 ENKL 的有前途的方案之一，但其骨髓毒性很强。由于全身性疾病进展和广泛的器官功能不全，ANKL 需要另一种治疗策略。应进一步探索使用此类有效药物治疗这些不利的 NK 细胞肿瘤的最佳治疗方案。
Extranodal NK/T cell lymphoma, nasal type (ENKL) with advanced stage and aggressive NK-cell leukemia (ANKL) are highly aggressive neoplasms with a dismal clinical outcome. It is well known that P-glycoprotein, which is a product of MDR1 gene and related to multi-drug resistance, is expressed on tumor cells of ENKL or ANKL. This is a major reason for the refractoriness to conventional chemotherapeutic regimens for malignant lymphoma containing anthracycline. However, recent studies have identified that several drugs including l-asparaginase, methotrexate and alkylators show excellent effect for these tumors. The SMILE (steroid, methotrexate, ifosfamide, l-asparaginase and etoposide) regimen is one of the promising regimens for advanced or relapsed/refractory ENKL, but its myelotoxicity is strong. ANKL needs another treatment strategy because of a systemic disease progression and extensive organ insufficiency. Optimal treatment scheme using such effective agents for these unfavorable NK-cell tumors should further be explored.