Efficacy and safety of pegaspargase and L-asparaginase in the treatment of NK/T-cell lymphoma / 国际肿瘤学杂志

ABSTRACT

Objective To compare the clinical efficacy and adverse effects of pegaspargase (PEGASP) and L-asparaginase (L-ASP) in the treatment of NK/T-cell lymphoma.Methods A retrospective analysis was conducted on the clinical data of 46 patients with NK/T-cell lymphoma in Department of Oncology of Hospital of Qingdao Commercial Staff from September 2009 to July 2015.There were 24 patients treated by PEG-ASP combined with GDP (gemcitabine + cisplatin + dexamethasone) as PEG-ASP group,and 22 patients treated by L-ASP combined with GDP as L-ASP group.The efficacy and adverse reactions were compared between the two groups.Results In the PEG-ASP group,there were 11 patients with complete remission,7 patients with partial remission,and the complete remission rate and objective response rate were 45.83％ and 75.00％.In the L-ASP group,there were 9 patients with complete remission,6 patients with partial remission,and the complete remission rate and objective response rate were 40.91％ and 68.18％.There was no significant difference between the two groups in objective response rate (x2 =0.263,P =0.608).Adverse effects such as myelosuppression (25.00％ vs.22.73％,x2 =0.033,P =0.857),coagulopathy (8.33％ vs.9.10％,x2=0.008,P =0.927),liver and renal dysfunction (8.33％ vs.18.18％,x2 =0.982,P=0.322),gastrointestinal reaction (41.67％ vs.40.91％,x2 =0.003,P =0.958) were similar in the PEGASP group and L-ASP group.But the risk of allergic reaction incurred by PEG-ASP was much lower than L-ASP (4.17％ vs.36.36％),with a significant difference (x2 =7.561,P =0.006).Moreover,the PEGASP group had a shorter duration of hospitalization [(10.04 ± 1.63) d] than the L-ASP group [(13.09 ± 2.76)d],with a significant difference (t=-4.612,P=0.000).Conclusion The efficacy of PEG-ASP and L-ASP in the treatment of NK/T-cell lymphoma is similar,but the rate of allergic reaction of patients treated with PEG-ASP is significantly lower,and the hospitalization time is significantly shorter,which is worthy of further clinical application.