Single-drug vinblastine as salvage treatment for refractory or relapsed anaplastic large-cell lymphoma: a report from the French Society of Pediatric Oncology.

Abstract

PURPOSE:

To evaluate the efficacy of vinblastine for relapsed/refractory anaplastic large-cell lymphoma (ALCL).

PATIENTS AND METHODS:

Data were reviewed on all 36 patients included prospectively in the French database for pediatric ALCL who were treated with vinblastine (6 mg/m(2)/wk) for resistant primary disease (one), a first relapse (15), or subsequent relapses (20). Fifteen patients had undergone hematopoietic stem-cell transplantation (HSCT) for a previous relapse.

RESULTS:

Six patients were not evaluable for response, 25 (83%) of 30 evaluable patients achieved a complete remission (CR), and five experienced progressive disease. Among the 31 patients who achieved a CR with vinblastine or before its initiation, six patients were treated with HSCT and 25 with vinblastine alone (median duration, 14 months). Overall, nine of 25 patients treated with vinblastine alone have remained in CR (median, 7 years since the end of treatment), and 16 patients have relapsed. Vinblastine was still efficient for subsequent relapses. With a median follow-up of 9.2 years, 12 patients have died (four as a result of toxicity after HSCT and eight as a result of disease), and 24 patients are alive (15 following treatment with single-agent vinblastine for the last event). Five-year overall survival is 65% (95% CI, 48% to 79%), and 5-year event-free survival is 30% (95% CI, 17% to 47%).

CONCLUSION:

Vinblastine is highly efficient in relapsed ALCL and may produce durable remissions. The optimal treatment duration still has to be assessed. These results should be borne in mind when designing future phase II studies with the targeted therapies directed against anaplastic lymphoma kinase.

• Authors: Laurence Brugières, Helene Pacquement, Marie-Cecile Le Deley, Guy Leverger, Patrick Lutz, Catherine Paillard, Andre Baruchel, Didier Frappaz, Brigitte Nelken, Laurence Lamant, Catherine Patte
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 27 Issue 30 Pg. 5056-61 (Oct 20 2009) ISSN: 1527-7755 [Electronic] United States
• PMID: 19738127 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents
• Vinblastine

Topics

• Antineoplastic Agents (therapeutic use)
• Child
• Humans
• Lymphoma, Large-Cell, Anaplastic (drug therapy)
• Neoplasm Recurrence, Local (drug therapy)
• Prospective Studies
• Survival Analysis
• Treatment Outcome
• Vinblastine (therapeutic use)