We retrospectively reviewed the clinical courses of 12 consecutively-diagnosed cases of localized, nasal NK-cell lymphoma. All patients revealed a phenotype of CD2+CD3 (Leu4)-cytoplasmic CD3ε+CD5-CD45+CD56+. Nine patients were stage I, and three stage II. Seven patients were initially treated with an anthracycline-containing regimen (Group 1). All but one patient failed to achieve a complete response (CR) and died of lymphoma within six months of diagnosis. All patients with B symptoms and/or an elevated serum LDH level in Group 1 died. The remaining five patients were treated first with radiotherapy (Group 2). After radiotherapy, two patients were treated with anthracycline-containing regimens, and one patient was treated with carboplatin, etoposide, ifosfamide, and dexamethasone (DeVIC). Two patients were treated concurrently with radiotherapy and DeVIC (RT-DeVIC): one showed B symptoms, and both had high serum LDH levels. All five patients in Group 2 achieved CR and four patients are alive with no evidence of recurrence. Based on the present study and a review of the literature, radiotherapy followed by, or combined with, chemotherapy is highly recommended as the initial treatment modality for localized nasal NK-cell lymphoma.
by The Japanese Society for Lymphoreticular Tissue Research