This protocol addresses fit patients with limited-stage (stage I–II) extranodal NK/T-cell lymphoma who are able to tolerate chemotherapy but are not eligible for haematopoietic stem-cell transplantation (HSCT). The treatment strategy for this population differs from that used in transplant-eligible patients at the same stage, and the full protocol specifies the appropriate approach for these patients.
The approach for HSCT-ineligible patients in this setting involves combining involved-site radiotherapy with an anthracycline-free, L-asparaginase-containing chemotherapy regimen — the full protocol details the scheduling options, regimen selection, and any necessary modifications.
A key clinical goal is monitoring Epstein-Barr virus (EBV) DNA levels in peripheral blood as a biomarker of treatment response, alongside imaging-based assessment.
References
DOI: 10.1016/j.annonc.2025.01.023
Fit patients with limited-stage disease should receive ISRT (50 Gy) with concurrent, interposed or sequential anthracycline-free, L-asparaginase-containing ChT [e.g. DDGP or modified SMILE (mSMILE) for HSCT-eligible and AspMetDex or P-GEMOX for HSCT-ineligible patients] [II, A].
EBV DNA in peripheral blood should be monitored by quantitative PCR at baseline and during therapy as a biomarker of response, in addition to imaging-based response assessment [II, A].
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