Excellent survival following two courses of COPAD chemotherapy in children and adolescents with resected localized B-cell non-Hodgkin's lymphoma: results of the FAB/LMB 96 international study
Excellent survival following two courses of COPAD chemotherapy in children and adolescents with resected localized B-cell non-Hodgkin's lymphoma: results of the FAB/LMB 96 international study
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DOI：
10.1111/j.1365-2141.2008.07144.x
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发表时间：
2008-06-01
影响因子：
6.5
通讯作者：
Patte, Catherine
中科院分区：
文献类型：
--
作者：
Gerrard, Mary;Cairo, Mitchell S.;Patte, Catherine
采用多种化疗策略治疗儿童局限性成熟B细胞淋巴瘤（B NHL）可获得较高的治愈率。为了减少晚期后遗症，化疗的持续时间和强度已逐渐减少。Lymphome Malins de Burkitt（LMB）89研究报告了几乎所有接受两个疗程COPAD（环磷酰胺、长春新碱、泼尼松龙和多柔比星）治疗的局部切除疾病儿童的长期生存率。本研究旨在确认该方法在多国合作研究中大量患者中的有效性。患者队列是一项国际研究（法国-美国-英国LMB 96）的一部分，该研究包括所有疾病阶段，涉及三个国家组。本部分研究中的患者已切除I期或完全切除腹部II期疾病。手术后，给予两个疗程的COPAD，没有鞘内（IT）化疗。132名儿童可评价。264个疗程中有2个（0.9%）与IV级毒性相关（1例口腔炎和1例感染）。中位随访50.5个月，4年无事件生存率为98.3%，总生存率为99.2%。儿童局部B-NHL切除后，可以治愈与最小的毒性后，两个疗程的低强度治疗没有IT化疗。
High cure rates are possible in children with localized mature B-cell lymphoma (B NHL) using a variety of chemotherapeutic strategies. To reduce late sequelae, the duration and intensity of chemotherapy has been progressively reduced. The Lymphome Malins de Burkitt (LMB) 89 study reported long-term survival in almost all children with localized resected disease treated with two courses of COPAD (cyclophosphamide, vincristine, prednisolone and doxorubicin). This study was designed to confirm the effectiveness of this approach in a larger number of patients in a multinational co-operative study. The patient cohort was part of an international study (French-American-British LMB 96), which included all disease stages and involved three national groups. Patients in this part of the study had resected stage I or completely resected abdominal stage II disease. Following surgery, two courses of COPAD were given, without intrathecal (IT) chemotherapy. One hundred and thirty-two children were evaluable. Two of 264 (0.9%) courses were associated with grade IV toxicity (one stomatitis and one infection). With a median follow up of 50.5 months, the 4 year event-free survival is 98.3% and overall survival is 99.2%. Children with resected localized B-NHL can be cured with minimal toxicity following two courses of low intensity treatment without IT chemotherapy.