Extranodal NK/T-cell lymphoma nasal type: efficacy of pegaspargase. Report of two patients from the United Sates and review of literature.

Extranodal NK/T cell lymphoma nasal type is an EBV driven non-Hodgkin lymphoma, rare in the United States, with no known satisfactory treatment. Two patients with this entity refractory to CHOP chemotherapy responded to single agent pegaspargase (pegylated L-asparaginase). A 64-year-old Caucasian woman presented with extranodal NK/T lymphoma nasal type on her left buttocks. After initial treatment with loco-regional irradiation and CHOP, she developed extensive lower extremity lesions, and subsequent paranasal sinus involvement. With pegaspargase, she had a dramatic improvement of her skin lesions and proceeded to autologous stem cell transplant. A 48 year old Asian man presented with nasal cavity extranodal NK/T lymphoma which resolved with radiation therapy. Multiple liver lesions which developed while receiving CHOP completely resolved on pegaspargase. L- Asparaginase and its pegylated form have activity in this disease and further exploration alone or in combination is warranted.