Disseminated nonlymphoblastic lymphoma of childhood: a Childrens Cancer Group study, CCG-552.

Abstract

PURPOSE:

To assess the efficacy of a chemotherapy-only regimen in pediatric patients with disseminated non-lymphoblastic lymphoma and acute B-cell leukemia (B-ALL).

PATIENTS AND METHODS:

Sixty-eight eligible patients with previously untreated disseminated non-lymphoblastic lymphoma were enrolled on a Childrens Cancer Group study. Therapy included cycles of chemotherapy, systemic and intrathecal (IT), ever 3 weeks for a total maximal duration of 57 weeks. Fifty-five patients had small non-cleaved cell lymphoma (SNCCL) and 13 had diffuse large cell lymphoma (DLCL). Forty-seven were stage III, six were stage IV, and 15 had B-ALL; 13 had central nervous system (CNS) involvement.

RESULTS:

Four year event-free survival (EFS) was 53% (SE +/- 12%). Stage III SNCCL patients with LDH < 500 IU/L achieved an improved EFS compared to other SNCCL patients (86% vs. 42% 4 year EFS, P = .072). The primary site of failure for advanced stage SNCCL patients was the CNS. All Ki-1-positive DLCL patients relapsed. Patterns of failure, time to relapse, and outcome following relapse differed between SNCCL and DLCL patients.

CONCLUSIONS:

Advanced stage SNCCL requires better CNS-directed chemotherapy to reduce the CNS failure rate; however, the achievement of durable disease-free survival in four of 11 patients with CNS disease without use of cranial irradiation suggests merit for further evaluation of chemotherapy-only strategies. DLCL patients do not need intensive CNS-directed chemotherapy.

• Authors: J L Finlay, J R Anderson, A J Cecalupo, R J Hutchinson, M E Kadin, C R Kjeldsberg, A J Provisor, W G Woods, A T Meadows
• Journal: Medical and pediatric oncology (Med Pediatr Oncol) Vol. 23 Issue 6 Pg. 453-63 ( 1994) ISSN: 0098-1532 [Print] United States
• PMID: 7935170 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Cytarabine
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone
• Hydrocortisone
• Methotrexate

Topics

• Adolescent
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Burkitt Lymphoma (drug therapy)
• Child
• Child, Preschool
• Cyclophosphamide (administration & dosage)
• Cytarabine (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Female
• Humans
• Hydrocortisone (administration & dosage)
• Lymphoma, Large B-Cell, Diffuse (drug therapy)
• Lymphoma, Large-Cell, Anaplastic (drug therapy)
• Lymphoma, Non-Hodgkin (drug therapy)
• Male
• Methotrexate (administration & dosage)
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Prednisone (administration & dosage)
• Remission Induction
• Treatment Outcome
• Vincristine (administration & dosage)