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Blood, 1 April 2007, Vol. 109, No. 7, pp. 2773-2780. Prepublished online as a Blood First Edition Paper on November 28, 2006; DOI 10.1182/blood-2006-07-036673. This Article Full Text Full Text (PDF) Supplemental Appendix All Versions of this Article: blood-2006-07-036673v1 109/7/2773    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 Patte, C. Articles by Cairo, M. S. Search for Related Content PubMed PubMed Citation Articles by Patte, C. Articles by Cairo, M. S. 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 the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients Catherine Patte1, Anne Auperin2, Mary Gerrard3, Jean Michon4, Ross Pinkerton5, Richard Sposto6, Claire Weston7, Martine Raphael8, Sherrie L. Perkins9, Keith McCarthy10, Mitchell S. Cairo11, for the FAB/LMB96 International Study Committee12 1 Institut Gustave Roussy, Pediatric Department, Villejuif, France; 2 Institut Gustave Roussy, Biostatistics and Epidemiology Department, Villejuif, France; 3 Sheffield Children's Hospital, Sheffield, United Kingdom; 4 Institut Curie, Pediatric Department, Paris, France; 5 Royal Marsden Hospital, Sutton, Surrey, United Kingdom; 6 Keck School of Medicine, University of Southern California, Los Angeles, CA; 7 University of Leicester, Leicester, United Kingdom; 8 Centre Hospitalier Universitaire (CHU) Bicêtre Assistance Publique–Hôpitaux de Paris (AP-HP), University Paris Sud 11, France; 9 University of Utah Health Sciences Center, Salt Lake City, UT; 10 Gloucestershire Hospitals, National Health Service (NHS) Foundation Gloucestershire, United Kingdom; 11 Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY; 12 Children's Oncology Group (COG), Arcadia, CA, Société Française d'Oncologie Pédiatrique (SFOP), France, and the United Kingdom Children's Cancer Study Group (UKCCSG), Leicester, United Kingdom A previous study (LMB89) of the French Society of Pediatric Oncology for childhood mature B-cell lymphoma (B-NHL) demonstrated a 92% 3-year event-free survival (EFS) for intermediate-risk group B defined as "non-resected" stage I/II and CNS-negative advanced-stage III/IV (70% of cases). We performed the FAB/LMB96 trial to assess the possibility of reducing treatment in children/adolescents with intermediate-risk B-NHL without jeopardizing survival. "Early responding" patients (tumor response > 20% at day 7) were randomized in a factorial design between 4 arms, 2 receiving half-dose of cyclophosphamide in the second induction course with cyclophosphamide, Oncovin (vincristine), prednisone, Adriamycin (doxorubicin), methotrexate (COPADM) and 2 not receiving the maintenance course M1. A total of 657 patients were randomized (May 1996 to June 2001) and 637 were analyzed. The analysis showed no significant effect of any of the treatment reductions on EFS and survival. The 4-year EFS was 93.4% and 90.9% in the groups with full-dose and half-dose of cyclophosphamide (RR = 1.3, P = .40) and 91.9% and 92.5% in the groups with and without M1 (RR = 1.01, P = .98). There was no interaction between the 2 treatment reductions or between each treatment reduction and LDH level or histologic subtypes (Burkitt/Burkitt-like or large B-cell). Children/adolescents with intermediate-risk B-NHL who have an early response and achieve a complete remission after the first consolidation course can be cured with a 4-course treatment with a total dose of only 3.3 g/m2 cyclophosphamide and 120 mg/m2 doxorubicin. 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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