Outcome of children with B cell lymphoma in Venezuela with the LMB-89 protocol.

Abstract

BACKGROUND:

We analyzed the results of the LMB-89 protocol performed in seven centers in Venezuela in 96 children having B-cell non-Hodgkin lymphoma treated from 1995 to 2002.

PROCEDURE:

Mean age was 7.1 years with 71 (74%) been male. Eighty-two patients (85%) had diffuse small cell lymphoma Burkitt and Burkitt-like, and 14 (15%) had diffuse large B-cell lymphoma. Initial disease sites included the abdomen in 67%, peripheral nodes in 8%, and mediastinal in 4%. Treatment was directed to risk groups as described for LMB-89 protocol. Group A: seven patients (7%), group B: 80 patients (83%), and group C: nine patients (9%).

RESULTS:

Mean follow-up was 35 +/- 31 months. Complete remission (CR) occurred in 70 patients (73%); four patients (6%) had relapse during the first year and ten patients (10%) had progressive disease. Overall survival (OS) and event free survival (EFS) were 85 and 80% at 1 year, and 82 and 75% at 2 years, respectively. The EFS by therapeutic groups at 3 years was A: 100%; B: 76%, and C: 56%.

TOXICITY:

neutropenia in 75%, thrombocytopenia in 63%, febrile neutropenia in 39%. Viral infections: hepatitis B in 20%, hepatitis C in 2%, and Herpes zoster in 3%. Tumor lysis syndrome (TLS) occurred in 9% during induction phase with a high mortality of 44% (urate-oxidase was available only at the end of the study).

CONCLUSIONS:

The high mortality rate during induction phase prohibited a better EFS. Prophylactic use of xantine-oxidase may improve future results. The high incidence of hepatitis B requires a vaccination program.

• Authors: G Acquatella, C L Insausti, R García, R Gómez, M Hernández, M Carneiro, S Santos, A Nouel
• Journal: Pediatric blood & cancer (Pediatr Blood Cancer) Vol. 43 Issue 5 Pg. 580-6 (Oct 2004) ISSN: 1545-5009 [Print] United States
• PMID: 15382276 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2004 Wiley-Liss, Inc.

Chemical References

• Hepatitis B Vaccines
• Cytarabine
• Vincristine
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Leucovorin
• Prednisone
• Hydrocortisone
• Methotrexate

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Child
• Cyclophosphamide (administration & dosage)
• Cytarabine (administration & dosage)
• Disease Progression
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Etoposide (administration & dosage)
• Female
• Hepatitis B (complications, prevention & control)
• Hepatitis B Vaccines (administration & dosage)
• Humans
• Hydrocortisone (administration & dosage)
• Leucovorin (administration & dosage)
• Lymphoma, B-Cell (drug therapy, pathology)
• Lymphoma, Non-Hodgkin (drug therapy, pathology)
• Male
• Methotrexate (administration & dosage)
• Prednisone (administration & dosage)
• Recurrence
• Treatment Outcome
• Venezuela
• Vincristine (administration & dosage)