Improved outcome in children with advanced stage B-cell non-Hodgkin's lymphoma (B-NHL): results of the United Kingdom Children Cancer Study Group (UKCCSG) 9002 protocol

Citation
A. Atra et al., Improved outcome in children with advanced stage B-cell non-Hodgkin's lymphoma (B-NHL): results of the United Kingdom Children Cancer Study Group (UKCCSG) 9002 protocol, BR J CANC, 82(8), 2000, pp. 1396-1402
Citations number
26
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
BRITISH JOURNAL OF CANCER
ISSN journal
0007-0920 → ACNP
Volume
82
Issue
8
Year of publication
2000
Pages
1396 - 1402
Database
ISI
SICI code
0007-0920(200004)82:8<1396:IOICWA>2.0.ZU;2-U
Abstract
From July 1990 to March 1996, 112 children with stage III or IV B-cell non- Hodgkin's lymphoma (B-NHL) with up to 70% FAB L3-type blasts (n = 42) in th e bone marrow without central nervous system (CNS) disease were treated on the United Kingdom Children Cancer Study Group (UKCCSG) 9002 protocol (iden tical to the French LMB 84). The median age was 8.3 years. There were 81 ba ys and 31 girls. According to the extent of the primary disease, patients w ere sub-staged into three groups: IIIA with unresectable abdominal tumour ( n = 39); IIIB with abdominal multiorgan involvement (n = 57) and IIIX with extra-abdominal primary lymphoma often presenting as pleural effusion (n = 16). Univariate and multivariate analyses were carried out to evaluate the prognostic significance of lactate dehydrogenase (LDH) level at diagnosis, the sub-stage and the time to achieve complete remission (CR), With a media n follow up of 48 months (range 12-92), the overall and event free survival (EFS) is 87% (95% confidence interval (CI) 79.2-92.1%) and 83.7% (95% GI 7 6.3-89.2%) respectively. Six patients (5.4%) never achieved GR, of whom one is alive following high-dose therapy. Eight patients (7.1%) relapsed after achieving CR, three are alive after second-line therapy. There were three early toxic deaths (2.7%), mainly from infection, and one late death from a second cancer, There was no significant difference in EFS according to LDH level at diagnosis, the sub-stage or the time to CR. This study confirms t he overall good prognosis and low rate of toxic deaths in patients with adv anced B-NHL treated with this intensive regimen. No significant difference in EFS according to the sub-stage, the time to achieve CR or LDH level at d iagnosis making it difficult to identify a group that should not receive in tensive therapy. (C) 2000 Cancer Research Campaign.