Abstract
From June 1990 to February 1996, 35 patients with B-cell acute lymphoblastic leukaemia (B-ALL) 13 of whom had CNS disease and 28 patients with stage IV B-cell non-Hodgkin's lymphoma (B-NHL) 22 of whom had CNS involvement were treated with a short, intensive multiagent chemotherapy regimen (UKCCSG 9003 protocol) based on the French LMB 86 regimen. Fifty-five were boys. The age range was 11 months to 16.5 years (median 8.4 years). Chemotherapy included cyclophosphamide, vincristine, daunorubicin, high-dose methotrexate (COPADM) and etoposide/high-dose cytarabine (CYVE) with frequent intrathecal (i.t.) triple therapy (methotrexate, cytarabine and hydrocortisone). Cranial irradiation (24 Gy in 15 fractions) was recommended in patients with overt CNS disease. One patient with Wiskott-Aldrich syndrome was withdrawn after entry and has been excluded from the analysis. Ten patients (16%) have relapsed (CNS, four; BM, two; combined CNS and BM, three; and jaw, one) 4-11 months after diagnosis and two patients never achieved complete remission (CR). All have died. In seven of the patients who relapsed, treatment had been modified or delayed because of poor clinical condition. Seven patients (11%) died of toxicity 11 days to 4 months after diagnosis. The cause of death was sepsis (n = 5) or sepsis with renal failure (n = 2). With a median follow-up of 3.1 years from diagnosis (range 9 months to 6.3 years), 43 patients (69%) survive in CR. This study confirms the effectiveness of this regimen with regard to the relapse rate (16%), although the rate of toxic death is of concern.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Al-Attar A., Pritchard J., Al-Saleem T., Al-Naimi M., Alash N., Attra A. Intensive chemotherapy for non-localised Burkitt's lymphoma. Arch Dis Child. 1986 Oct;61(10):1013–1019. doi: 10.1136/adc.61.10.1013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Allegretta G. J., Weisman S. J., Altman A. J. Oncologic emergencies I. Metabolic and space-occupying consequences of cancer and cancer treatment. Pediatr Clin North Am. 1985 Jun;32(3):601–611. doi: 10.1016/s0031-3955(16)34826-x. [DOI] [PubMed] [Google Scholar]
- Bowman W. P., Shuster J. J., Cook B., Griffin T., Behm F., Pullen J., Link M., Head D., Carroll A., Berard C. Improved survival for children with B-cell acute lymphoblastic leukemia and stage IV small noncleaved-cell lymphoma: a pediatric oncology group study. J Clin Oncol. 1996 Apr;14(4):1252–1261. doi: 10.1200/JCO.1996.14.4.1252. [DOI] [PubMed] [Google Scholar]
- Gentet J. C., Patte C., Quintana E., Bergeron C., Rubie H., Pein F., Demaille M. C., Philip T., Raybaud C. Phase II study of cytarabine and etoposide in children with refractory or relapsed non-Hodgkin's lymphoma: a study of the French Society of Pediatric Oncology. J Clin Oncol. 1990 Apr;8(4):661–665. doi: 10.1200/JCO.1990.8.4.661. [DOI] [PubMed] [Google Scholar]
- Hann I. M., Eden O. B., Barnes J., Pinkerton C. R. 'MACHO' chemotherapy for stage IV B cell lymphoma and B cell acute lymphoblastic leukaemia of childhood. United Kingdom Children's Cancer Study Group (UKCCSG). Br J Haematol. 1990 Nov;76(3):359–364. doi: 10.1111/j.1365-2141.1990.tb06368.x. [DOI] [PubMed] [Google Scholar]
- Masera G., Jankovic M., Zurlo M. G., Locasciulli A., Rossi M. R., Uderzo C., Recchia M. Urate-oxidase prophylaxis of uric acid-induced renal damage in childhood leukemia. J Pediatr. 1982 Jan;100(1):152–155. doi: 10.1016/s0022-3476(82)80259-x. [DOI] [PubMed] [Google Scholar]
- Patte C., Philip T., Rodary C., Bernard A., Zucker J. M., Bernard J. L., Robert A., Rialland X., Benz-Lemoine E., Demeocq F. Improved survival rate in children with stage III and IV B cell non-Hodgkin's lymphoma and leukemia using multi-agent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. J Clin Oncol. 1986 Aug;4(8):1219–1226. doi: 10.1200/JCO.1986.4.8.1219. [DOI] [PubMed] [Google Scholar]
- Patte C., Philip T., Rodary C., Zucker J. M., Behrendt H., Gentet J. C., Lamagnère J. P., Otten J., Dufillot D., Pein F. High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol. 1991 Jan;9(1):123–132. doi: 10.1200/JCO.1991.9.1.123. [DOI] [PubMed] [Google Scholar]
- Philip T., Lenoir G. M., Bryon P. A., Gerard-Marchant R., Souillet G., Philippe N., Freycon F., Brunat-Mentigny M. Burkitt-type lymphoma in France among non-Hodgkin malignant lymphomas in Caucasian children. Br J Cancer. 1982 May;45(5):670–678. doi: 10.1038/bjc.1982.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reiter A., Schrappe M., Parwaresch R., Henze G., Müller-Weihrich S., Sauter S., Sykora K. W., Ludwig W. D., Gadner H., Riehm H. Non-Hodgkin's lymphomas of childhood and adolescence: results of a treatment stratified for biologic subtypes and stage--a report of the Berlin-Frankfurt-Münster Group. J Clin Oncol. 1995 Feb;13(2):359–372. doi: 10.1200/JCO.1995.13.2.359. [DOI] [PubMed] [Google Scholar]
- Schwenn M. R., Blattner S. R., Lynch E., Weinstein H. J. HiC-COM: a 2-month intensive chemotherapy regimen for children with stage III and IV Burkitt's lymphoma and B-cell acute lymphoblastic leukemia. J Clin Oncol. 1991 Jan;9(1):133–138. doi: 10.1200/JCO.1991.9.1.133. [DOI] [PubMed] [Google Scholar]
- al-Attar A., Attra A., al-Bagdadi R., al-Naimi M., al-Saleem T., Pritchard J. 'Debulking' surgery is unnecessary in advanced abdominal Burkitt lymphoma in Iraq. Br J Cancer. 1989 Apr;59(4):610–612. doi: 10.1038/bjc.1989.123. [DOI] [PMC free article] [PubMed] [Google Scholar]