Abstract | PURPOSE: The Pediatric Oncology Group (POG) adopted a histology-based approach to the management of pediatric non-Hodgkin's lymphomas (NHL) utilizing the National Cancer Institute Working Formulation for Clinical Usage. Patients with diffuse large cell lymphoma (DLCL) were treated on a separate protocol from small cell diffuse undifferentiated or lymphoblastic lymphomas. This study assessed the overall and event free survival of children with DLCL and determined the effects of cyclophosphamide upon these end-points in a prospective randomized trial. PATIENTS AND METHODS: RESULTS: The 5-year event free survival (EFS) rates of patients treated with ACOP+ versus APO were 62+/-7 and 72+/-6%, respectively. While there was no statistically significant difference between the two treatment arms (p = 0.28), we can only say that we are 95% confident that the difference in 5-year EFS falls in the wide range from 28% in favor of APO to 8% favoring ACOP+. Marrow suppression was the main toxicity with one fatal infection. There were three other deaths on study due to respiratory failure in patients with mediastinal masses. Only one patient experienced cardiotoxicity requiring discontinuation of doxorubicin. Ten patients received radiation therapy to achieve remission. CONCLUSION: The efficacy of elimination of cyclophosphamide from the treatment program of children and adolescents with advanced stage diffuse large cell lymphoma was inconclusive as to its effect on EFS. Furthermore, the majority of the patients (92%) did not require any radiation therapy to bulky disease indicating that the chemotherapy regimens are quite efficient for achievement of complete remission.
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Authors | Joseph H Laver, Hazem Mahmoud, Terry E Pick, Robert E Hutchison, Howard J Weinstein, Molly Schwenn, Sheilah Weitzman, Sharon B Murphy, Stephanie Ochoa, Jonathan J Shuster |
Journal | Leukemia & lymphoma
(Leuk Lymphoma)
Vol. 43
Issue 1
Pg. 105-9
(Jan 2002)
ISSN: 1042-8194 [Print] United States |
PMID | 11908712
(Publication Type: Clinical Trial, Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Vincristine
- Doxorubicin
- Cyclophosphamide
- Mercaptopurine
- Prednisone
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Topics |
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, therapeutic use)
- Child
- Cyclophosphamide
(administration & dosage, therapeutic use)
- Disease-Free Survival
- Doxorubicin
(administration & dosage)
- Female
- Humans
- Lymphoma, Large B-Cell, Diffuse
(drug therapy, mortality, radiotherapy)
- Male
- Mercaptopurine
(administration & dosage)
- Prednisone
(administration & dosage)
- Prospective Studies
- Recurrence
- Remission Induction
(methods)
- Survival Rate
- Treatment Outcome
- Vincristine
(administration & dosage)
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