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Lymphoblastic lymphoma in adults: results of a pilot protocol
CN Coleman, JR Cohen, JS Burke and SA Rosenberg
Thirteen adult patients with histologically confirmed lymphoblastic
lymphoma were treated with an intensive chemotherapy program consisting of
induction with cyclophosphamide, adriamycin, vincristine, and prednisone
(modified CHOP); consolidation and central nervous system (CNS) prophylaxis
with methotrexate intrathecally and by high-dose intravenous injection,
citrovorum factor and L-asparaginase; reinforcement with CHOP; and
maintenance with 6-mercaptopurine and methotrexate. Treatment duration was
1 yr. A 14th patient with T-cell acute lymphoblastic leukemia was also
treated at presentation by the same regimen. Thirteen patients had at least
a mediastinal mass or abnormal cells in the bone marrow; one presented with
CNS disease. The median age was 22 yr (range 16--50), and male--female
ratio was 2.5:1. All patients had a rapid complete clinical response. Of
the 13 patients without initial CNS disease, 4 have relapsed, 3 with
primary CNS relapse and 1 with a recurrent abdominal mass. Five patients
have died, 2 from drug toxicity, 2 from CNS relapse, and 1 from chronic
myelogenous leukemia, which was diagnosed simultaneously with the
lymphoblastic lymphoma. The median follow-up is 19 mo, and all patients
have completed their planned therapy. At 3 yr, the actuarial survival is
61% and relapse-free survival is 56%.
Volume 57,
Issue 4,
pp. 679-684,
04/01/1981
Copyright © 1981 by The American Society of Hematology
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