EXTRANODAL'NK/T'CELL'LYMPHOMAI'REVIEW'OF'8'CASES'FROM'A'SINGLE'
POSTER'33'
CENTER'IN'INDIA'
'
Dr.Mintu!Mathew!Abraham1,!Dr.Geetha!N1,!Dr.Sreejith!Nair1,!Dr.Prakash!N!P1!and!Dr.Jayasudha!A!V2!!
!
(1)Department! of! Medical! Oncology,! Regional! Cancer! Centre,! Thiruvananthapuram,! India,!
(2)Department!of!Pathology,Regional!Cancer!Center,!Thiruvananthapuram,!India!
!
Introduction'!
Extranodal!natural!killer!(NK)/TJcell!lymphoma!is!an!aggressive!malignancy!of!NKJcell!origin,!
with! a! minority! deriving! from! the! TJcell! lineage.!The! lymphoma! is! locally! invasive! and! has!
most!commonly!a!nasal!origin!with!associated!infection!by!EpsteinJBarr!Virus(EBV).!There!is!
increased!incidence!in!Asian!and!South!American!populations,!and!it!is!uncommon!in!other!
countries.!
Materials'and'Methods!
This! is! a! retrospective! study! of! 8! patients! diagnosed! with! NK/T! cell! Lymphoma! treated! at!
Regional! Cancer! Center,! Trivandrum,! during! an! 8Jyear! period! from! January! 2010! to!
December! 2017.! The! case! records! of! the! patients! were! studied! with! respect! to! clinical!
presentation,!diagnosis,!treatment!received!and!survival.!
Results!
The!median!age!at!presentation!was!54!years.!There!were!7!males!and!one!female.!Epistaxis!
was!the!most!common!presenting!symptom!which!was!seen!in!4!patients.!Nasal!endoscopy!
and! biopsy! confirmed! a! diagnosis! of! NK/T! cell! LymphomaJNasal! type! in! all! patients.! EBV!
infection! related! markers! were! tested! in! 4! patients! all! of! whom! had! positivity.! Seven!
patients!had!stage!IE!and!one!had!stage!IIE!disease!by!Ann!Arbor!staging.!
Among! the! 8! patients,! 4! patients! received! the! SMILE! protocol! (Etoposide,Ifosfamide,!
Methotrexate,Dexamethasone),! 3! received! the! CHOP! (Cyclophosphamide,Doxorubicin,!
Vincristine,Prednisolone)! regimen! and! 1! received! VIPD! (Etoposide,Ifosfamide,Cisplatin,!
Dexamethasone)!protocol.!Seven!patients!received!Radiotherapy!(RT)!to!the!local!site.!One!
patient!developed!Grade!3!neutropenia!and!hepatic!failure!after!the!4th!cycle!of!CHOP!and!
expired.! One! patient! had! progressive! disease(PD)! with! new! skin! lesions! on! CHOP! protocol!
and!another!had!progression!with!cranial!nerve!palsies!on!SMILE!protocol!and!both!expired!
shortly.!!
Five!patients!completed!the!planned!treatment!and!achieved!Complete!Remission!(CR).!The!
patient! who! received! VIPD! protocol! had! relapse! and! was! treated! with! Gemcitabine! and!
Oxaliplatin.!He!is!in!CR!with!No!Evidence!of!Disease(NED)!28!months!after!2nd!line!treatment!
with!an!Overall!Survival(OS)!of!60!months.!Another!patient!who!received!SMILE!protocol!had!
relapse! 2! months! after! achieving! CR! and! expired! shortly! afterwards.! Three! patients! in! our!
series!did!not!have!any!relapse!and!are!alive!NED.!Two!of!these!patients!who!received!SMILE!
protocol!and!one!who!received!CHOP!protocol!are!on!regular!follow!up!with!an!OS!of!38,56!
and!116!months!respectively.!
In! our! series! of! 8! patients,! the! median! OS! of! the! patients! is! 37! months! and! the! 2Jyear!
survival!is!50!percent.!
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES