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Curability of relapsed childhood B-cell non-Hodgkin's lymphoma after
intensive first line therapy: a report from the Societe Francaise
d'Oncologie Pediatrique
T Philip, O Hartmann, R Pinkerton, JM Zucker, JC Gentet, JP Lamagnere, H Berhendt, Y Perel, J Otten and P Lutz
Centre Leon Berard, Pediatric and Biostatistics Department, Lyon, France.
The very high cure rate in advanced B-cell non-Hodgkin's lymphoma in
children using intensive multiagent therapy has been previously reported by
the French Societe Francaise d'Oncologie Pediatrique lymphoma Malin B type
(LMB) group. To address the issue of salvageability in an unselected group
of patients who had all received the same front-line therapy, the outcome
of relapses following the LMB 84 (216 patients) protocol have been
reviewed. Fourteen percent of patients achieving complete remission (CR)
relapsed, ie, 27 of 195. Relapse sites comprised the central nervous system
(CNS) alone (6 cases), lung or mediastinum (2 cases), abdomen (8 cases),
head and neck (2 cases), or multifocal (9 cases). There were three early
deaths due to disease. Twenty-four patients received rescue chemotherapy
regimens and 15 were treated with high-dose chemotherapy and bone marrow
rescue (1 allogeneic). Of these, 9 were in second CR, 4 in second partial
remission, and 2 treated during progressive disease. One died in CR from
treatment-related toxicity. Ten relapsed postbone marrow transplant and 4
are alive disease free and probably cured. Two of the long-term survivors
had some delay during initial chemotherapy due to toxicity and two were
isolated CNS relapses. Twelve of 27 patients did not proceed to megatherapy
(12 of 12 died).
Volume 81,
Issue 8,
pp. 2003-2006,
04/15/1993
Copyright © 1993 by The American Society of Hematology
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