SMILE

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Indication

Advanced-stage NK-cell lymphomas

Regimen

Methotrexate with leucovorin 2 g/m2 IV over 6 h d1
Ifosfamide with mesna	1.5 g/m2 IV d2, 3 and 4
Dexamethasone 40 mg IV or oral	d2, 3 and 4
Etoposide	100 mg/m2 IV d2, 3 and 4
L-asparaginase (Leunase) 6000 U/m2 IV d8, 10, 12, 14, 16, 18 and 20
G-CSF r to be started on day 6. Cycles to be repeated every 28 days.

Supportive medications

Given for up to 6 cycles

Neither paper nor supplement specified the length of each cycle, but other SMILE regimens, e.g. Yamaguchi et al. 2011, describe 28-day cycles.

References

Motoko Yamaguchi Ritsuro Suzuki, Yok-Lam Kwong3 et al .Phase I study of dexamethasone, methotrexate, ifosfamide, l-asparaginase, and etoposide (SMILE) chemotherapy for advanced-stage, relapsed or refractory extranodal natural killer (NK)/T-cell lymphoma and leukemia

Yamaguchi M et al. Phase II Study of SMILE Chemotherapy for Newly Diagnosed Stage IV, Relapsed, or Refractory Extranodal Natural Killer (NK)/T-Cell Lymphoma, Nasal Type: The NK-Cell Tumor Study Group Study. JCO November 20, 2011 vol. 29 no. 33 4410-4416

M. Yamaguchi, Y. Kwong, Y. Maeda, C. Hashimoto, W. Kim et al Phase II study of SMILE chemotherapy for newly-diagnosed stage IV, relapsed or refractory extranodal NK/T-cell lymphoma, nasal type: NKTSG study

Medscape. Diagnosis and Management of Natural Killer-cell Malignancies: Treatment of Advanced-stage NK-cell Lymphoma (Nasal & Non-nasal)