Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents

Cairo, Mitchell S., Gerrard, Mary, Sposto, Richard, Auperin, Anne, Pinkerton, C. Ross, Raphael, Martine, McCarthy, Keith and Patte, Catherine (2007) Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents. Blood, 109 7: 2736-2743. doi:10.1182/blood-2006-07-036665


Author Cairo, Mitchell S.
Gerrard, Mary
Sposto, Richard
Auperin, Anne
Pinkerton, C. Ross
Raphael, Martine
McCarthy, Keith
Patte, Catherine
Title Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents
Journal name Blood   Check publisher's open access policy
ISSN 0006-4971
Publication date 2007-04-01
Year available 2006
Sub-type Article (original research)
DOI 10.1182/blood-2006-07-036665
Volume 109
Issue 7
Start page 2736
End page 2743
Total pages 8
Place of publication Washington, D.C., United States
Publisher American Society of Hematology
Language eng
Subject 1102 Cardiovascular Medicine and Haematology
Formatted abstract
The prognosis for higher risk childhood B-cell non-Hodgkin lymphoma has improved over the past 20 years but the optimal intensity of treatment has yet to be determined. Children 21 years old or younger with newly diagnosed B-cell non-Hodgkin lymphoma/B-cell acute lymphoblastic leukemia (B-NHL/B-ALL) with higher risk factors (bone marrow [BM] with or without CNS involvement) were randomized to standard intensity French-American-British/Lymphoma Malignancy B (FAB/LMB) therapy or reduced intensity (reduced cytarabine plus etoposide and deletion of 3 maintenance courses M2, M3, M4). All patients with CNS disease had additional high-dose methotrexate (8 g/m2) plus extra intrathecal therapy. Fifty-one percent had BM involvement, 20% had CNS involvement, and 29% had BM and CNS involvement. One hundred ninety patients were randomized. The probabilities of 4-year event-free survival (EFS) and survival (S) were 79%± 2.7% and 82% ± 2.6%, respectively. In patients in remission after 3 cycles who were randomized to standard versus reducedintensity therapy, the 4-year EFS after randomization was 90% ± 3.1% versus 80% ± 4.2% (one-sided P = .064) and S was 93% ± 2.7% versus 83% ± 4.0% (onesided P = .032). Patients with either combined BM/CNS disease at diagnosis or poor response to cyclophosphamide, Oncovin [vincristine], prednisone (COP) reduction therapy had a significantly inferior EFS and S (P < .001). Standardintensity FAB/LMB therapy is recommended for children with high-risk B-NHL (B-ALL with or without CNS involvement).
(Blood. 2007;109:2736-2743)
© 2007 by The American Society of Hematology
Keyword Prognosis
B-cell non-Hodgkin lymphoma
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Prepublished online as Blood First Edition Paper, November 30, 2006

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Thu, 14 Jan 2010, 22:57:08 EST by Simon Utteridge on behalf of Faculty Of Health Sciences