Complete remission in advanced blastic NK-cell lymphoma/leukemia in elderly patients using the hyper-CVAD regimen

Shapiro, M; Wasik, MA; Junkins-Hopkins, JM; Rook, AH; Vittorio, CC; Itakura, H; Frankel, MC; Georgala, S; Schuster, SJ

dc.contributor.author	Shapiro, M	en
dc.contributor.author	Wasik, MA	en
dc.contributor.author	Junkins-Hopkins, JM	en
dc.contributor.author	Rook, AH	en
dc.contributor.author	Vittorio, CC	en
dc.contributor.author	Itakura, H	en
dc.contributor.author	Frankel, MC	en
dc.contributor.author	Georgala, S	en
dc.contributor.author	Schuster, SJ	en
dc.date.accessioned	2014-03-01T01:53:06Z
dc.date.available	2014-03-01T01:53:06Z
dc.date.issued	2003	en
dc.identifier.issn	0361-8609	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/26852
dc.subject	blastic NK-cell lymphoma/leukemia	en
dc.subject	hyper-CVAD	en
dc.subject.classification	Hematology	en
dc.subject.other	LOWER RESPIRATORY-TRACT	en
dc.subject.other	EPSTEIN-BARR-VIRUS	en
dc.subject.other	LYMPHOBLASTIC LYMPHOMA	en
dc.subject.other	CD56(+) LYMPHOMA	en
dc.subject.other	ACUTE-LEUKEMIA	en
dc.subject.other	CD4(+)	en
dc.subject.other	NASAL	en
dc.subject.other	MALIGNANCIES	en
dc.subject.other	ASSOCIATION	en
dc.subject.other	PRECURSOR	en
dc.title	Complete remission in advanced blastic NK-cell lymphoma/leukemia in elderly patients using the hyper-CVAD regimen	en
heal.type	journalArticle	en
heal.language	English	en
heal.publicationDate	2003	en
heal.abstract	Although its cell of origin is still controversial, the blastic NK-cell leukemia/lymphoma clearly represents a distinct type of hematopoietic neoplasm that is particularly clinically aggressive when it occurs in elderly patients as a disseminated, multi-organ disease. Consistently effective treatments have not been developed for this malignancy. The present report describes two elderly patients with widespread blastic NK-cell leukemia/lymphoma involving the skin, bone marrow, peripheral blood, lymph nodes, and viscera. In both cases the malignant cells were CD56+, CD2+, and terminal deoxynucleotidyl transferase (TdT) positive with no detectable T-cell receptor (TCR) gamma chain gene rearrangement. The cells also exhibited a low CD45 expression and strong CD99 (mic-2) expression, as seen in immature lymphoid malignancies. The above findings support the precursor NK-cell, rather than mature NK- or non-NK-cell, origin of the malignant cells. It is noteworthy that the two patients achieved complete responses to treatment with hyper-CVAD (fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) alternating with high-dose methotrexate/cytarabine, a regimen currently utilized in acute lymphoblastic leukemia and high-grade lymphoma. The complete remission (CR) was sustained for 24 months in one patient who received four cycles (eight courses) of the treatment. It lasted 9 months in the second patient, who received only two cycles (four courses). If similar results are obtained with future patients, a randomized study comparing the hyper-CVAD regimen to other therapeutic strategies may be warranted. (C) 2003 Wiley-Liss, Inc.	en
heal.publisher	WILEY-LISS	en
heal.journalName	AMERICAN JOURNAL OF HEMATOLOGY	en
dc.identifier.isi	ISI:000184940300007	en
dc.identifier.volume	74	en
dc.identifier.issue	1	en
dc.identifier.spage	46	en
dc.identifier.epage	51	en