Effectiveness of L-asparaginase-based regimens compared to anthracycline-based regimens in newly diagnosed extranodal NK/T-cell lymphoma, nasal type: a single Mexican center experience.

Background: Extranodal NK/T-cell lymphoma, nasal type (ENKTCL) has a high prevalence in Asia and Latin American countries, such as Mexico, where it encompasses 40% of all T-cell non-Hodgkin lymphomas. Historically, responses to anthracycline-based therapies have been disappointing. Since data about the effectiveness of L-asparaginase-based regimens in Mexico are limited, we compared both therapies in our center.

Methods: We performed a retrospective cohort of patients with newly diagnosed ENKTCL, who were divided into two groups for treatment and analysis (group 1: L-asparaginase-based regimen and group 2: anthracycline-based regimen) between 2001 and 2016.

Results: Of 36 patients with newly-diagnosed ENKTCL, 33 received at least one cycle of chemotherapy (22 in group 1 and 11 in group 2). Over a median follow-up interval of 17 months (range, 0-167), a complete response (CR) was observed in 45.5% of patients in group 1, compared to 27% of group 2 (=0.45). Progression was more frequently observed in group 2 than in group 1 (54.5% vs. 18.4%, =0.04). The median overall survival (OS) was 44 months in group 1, compared to 5 months in group 2 (=0.012). The multivariate analysis showed that failure to achieve a CR after first-line therapy was the only significant factor for OS (HR, 3.04; 95% CI, 1.4-6.5; =0.005).

Conclusion: L-asparaginase-based regimens for patients with newly-diagnosed ENKTCL confer a survival advantage over anthracycline-based regimens.