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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2736-2743. Prepublished online as a Blood First Edition Paper on November 30, 2006; DOI 10.1182/blood-2006-07-036665. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-07-036665v1 109/7/2736    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Cairo, M. S. Articles by Patte, C. Search for Related Content PubMed PubMed Citation Articles by Cairo, M. S. Articles by Patte, C. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS 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 Mitchell S. Cairo1, Mary Gerrard2, Richard Sposto3, Anne Auperin4, C. Ross Pinkerton5, Jean Michon6, Claire Weston7, Sherrie L. Perkins8, Martine Raphael9, Keith McCarthy10, Catherine Patte4, and on behalf of the FAB LMB96 International Study Committee11 1 Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY; 2 Sheffield Children's Hospital, Sheffield, United Kingdom; 3 Keck School of Medicine, University of Southern California, Los Angeles, CA; 4 Institut Gustave Roussy, Paris, France; 5 Royal Marsden Hospital, Sutton, Surrey, United Kingdom; 6 Institut Curie, Villejuif, France; 7 University of Leicester, Leicester, United Kingdom; 8 University of Utah Health Sciences Center, Salt Lake City, UT; 9 Centre Hospitalier Universitaire (CHU) Bicêtre, Assistance Publique–Hôpitaux de Paris (AP-HP), University Paris Sud 11, France; 10 Gloucestershire Hospitals, National Health Service (NHS) Foundation Trust, Gloucestershire, United Kingdom; 11 Children's Oncology Group (COG), Arcadia, CA, Société Française d'Oncologie Pédiatrique (SFOP), Paris, France; and the United Kingdom Children's Cancer Study Group (UKCCSG), Leicester, United Kingdom 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 reduced-intensity 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% (one-sided 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). Standard-intensity FAB/LMB therapy is recommended for children with high-risk B-NHL (B-ALL with or without CNS involvement). CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Be careful what you wish for? Adele K. Fielding Blood 2007 109: 2673-2674. [Full Text] [PDF] This article has been cited by other articles: W. Klapper, M. Szczepanowski, B. Burkhardt, H. Berger, M. Rosolowski, S. Bentink, C. Schwaenen, S. Wessendorf, R. Spang, P. Moller, et al. Molecular profiling of pediatric mature B-cell lymphoma treated in population-based prospective clinical trials Blood, August 15, 2008; 112(4): 1374 - 1381. [Abstract] [Full Text] [PDF] A. Reiter Diagnosis and Treatment of Childhood Non-Hodgkin Lymphoma Hematology, January 1, 2007; 2007(1): 285 - 296. [Abstract] [Full Text] [PDF] J. T. Sandlund Should Adolescents with NHL Be Treated as Old Children or Young Adults? Hematology, January 1, 2007; 2007(1): 297 - 303. [Abstract] [Full Text] [PDF]

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