Efficacy And Clinical Analysis Of Combination Chemotherapy With L-asparaginase In Treating Patients With Peripheral T-cell Lymphoma

Objective:To present the efficacy and adverse effects of combination chemotherapy with L-asparaginase (L-ASP) in patients with peripheral T-cell lymphoma. At the same time, clinical features and prognostic factors of patients with peripheral T-cell lymphoma were investigated.Methods:We retrospectively analyzed134patients who were diagnosed as peripheral T-cell lymphoma(PTCL) and received combination chemotherapy with or without L-asparaginase between January2012and December2013in The First Affiliated Hospital of Zhejiang University School of Medicine. Among them102patients were newly diagnosed and32patients were relapsed. We compared the short-term efficacy such as complete remission (CR) rate, partial remission (PR) rate, overall remission (OR) rate and long-term efficacy such as overall survival(OS) rate, progressive free survival(PFS) rate and adverse effects. Furthermore, the clinical features and prognostic factors were retrospectively analyzed.Results:In the newly diagnosed patients, the OR rate of patients who received chemotherapy with L-asparaginase (L-ASP group) was apparently higher than the patients who received chemotherapy without L-asparaginase (non L-ASP group)(83.3%vs61.7%, P=0.016). Furthermore, the difference was especially obvious in patients who were in stage Ⅲ/Ⅳ(82.4%vs54.0%, P=0.007) or IPI score≥2(82.1%vs50.0%, P=0.006), both had statistical significance. The3-year OS rate of L-ASP group and non L-ASP group were48.9%and65.0%respectively (P=0.974) and the3-year PFS rate of L-ASP group and non L-ASP group were40.8%and61.0%respectively (P=0.479). Both had no statistical significance. In the relapsed patients, neither short-term efficacy nor long-term efficacy had statistical significance between L-ASP group and non L-ASP group. Although the incidence of adverse effects were higher in L-ASP group than non L-ASP group, they were mild in most cases and could be improved after supportive treatments. There was no difference in serious infection caused by Ⅲ-Ⅳ degree of neutropenia between the two groups. Other severe side-effects occurred in L-ASP group such as hematencephalon and acute pancreatitis were only in one case respectively. Multiple-factor analysis showed that the performance status score(ECOG) was an indepentdent risk factor which impacted the survival of these patients(P=0.011).Conclusions:Combination chemotherapy with L-asparaginase (L-ASP) showed better short-time clinical outcome in newly diagnosed peripheral T-cell lymphoma patients and the adverse effects were controllable. Large scale prospective clinical trial of using L-asparaginase containing chemotherapy as first line treatment for patient with peripheral T-cell lymphoma is worth developing and further researching. The performance status score(ECOG) was an indepentdent risk factor which impacted the survival of patients with PTCL.