Efficacy observation of gemcitabine regimen and CHOP-like regimen as the first-line treatment of extranodal NK/T-cell lymphoma

Abstract

Objective To compare the efficacy and safety of combined regimen of gemcitabine and CHOP-like regimen as the first-line treatment for primary extranodal NK/T-cell lymphoma. Methods A retrospective analysis was carried out in 39 newly treated patients with extranodal NK/T-cell lymphoma in Henan Provincial People's Hospital from March 2012 to March 2017, in which 11 patients were treated with gemcitabine regimen and 28 patients were treated with CHOP-like regimen. The complete remission (CR) rate, partial remission (PR) rate, overall remission rate (ORR), overall survival (OS) rate, progression free survival (PFS) rate, and adverse reactions in the two groups were compared. Results In gemcitabine group and CHOP-like group, there were 5 and 8 cases achieved CR, 3 and 5 cases achieved PR. There was no statistically significant difference in CR rates and ORR between the two groups (P= 0.453, P= 0.073). The estimated 3-year OS rate in the two groups were 75% and 33%, and the estimated 3-year PFS rate were 70% and 29%, respectively. There was statistically significant differences in OS and PFS between the two groups (χ 2= 5.606, P= 0.018; χ2= 3.924, P= 0.048). The univariate analysis showed that the treatment program (P= 0.018) and the high lactate dehydrogenase (LDH) (P= 0.007) affected the prognosis of patients. Multivariate analysis showed that the high LDH increased the risk of death in patients (RR= 6.331, 95% CI 2.339-17.136, P < 0.001). Treatment with gemcitabine regimen reduced the risk of death in patients (RR= 0.101, 95% CI 0.023-0.452, P= 0.003). Most of the adverse events were 1-2 levels, and the patients were well tolerated. Conclusion Compared with CHOP-like regimen, the combined regimen of gemcitabine can improve the survival time of the patients with extranodal NK/T-cell lymphoma and significantly improve the long-term efficacy. Key words: Lymphoma, extranodal NK-T-cell; Drug therapy, combination; Treatment outcome; Gemcitabine; Drug toxicity