Successful treatment with high-dose methotrexate/cytarabine regimen in a patient in SMILE regimen-resistant extranodal natural killer/T-cell lymphoma

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Other Title
  • Methotrexate/cytarabine大量療法が奏効したSMILE療法抵抗性の節外性NK/T細胞リンパ腫，鼻型
  • 症例報告 Methotrexate/cytarabine大量療法が奏効したSMILE療法 抵抗性の節外性 NK/T細胞リンパ腫,鼻型
  • ショウレイ ホウコク Methotrexate/cytarabine タイリョウ リョウホウ ガ ソウコウ シタ SMILE リョウホウ テイコウセイ ノ フシ ガイセイ NK/Tサイボウ リンパシュ,ビガタ

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Description

A 28-year-old man complained of pain in the oral mucosa and pharynx in March 2011, and then developed fever and generalized swelling of the cheek. In March 2012, a gum biopsy led to a diagnosis of extranodal natural killer/T-cell lymphoma (ENKL). 18F-FDG-PET revealed significant uptake in the mouth, tonsils, jawbone, shoulder blade, humerus, ilium, femur, and spleen. After two courses of the SMILE (dexamethasone, methotrexate (MTX), ifosfamide, L-asparaginase, etoposide) regimen, the response was stable disease. However, a high-dose MTX/cytarabine (MA) regimen was effective. After three courses of the MA regimen, a partial response was achieved. Then, allogeneic bone marrow transplantation from an unrelated donor was performed. At 10 months after transplantation, there was no sign of recurrence. Although the optimal treatment for ENKL refractory to the SMILE regimen has yet to be established, our case suggests the MA regimen to be a potentially effective treatment option.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 55 (1), 120-124, 2014

    The Japanese Society of Hematology

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