Treatment of B-cell lymphoma with LMB modified protocols in Africa -: Report of the French-African Pediatric Oncology Group (GFAOP)
Treatment of B-cell lymphoma with LMB modified protocols in Africa -: Report of the French-African Pediatric Oncology Group (GFAOP)
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DOI：
10.1002/pbc.21452
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发表时间：
2008-06-01
影响因子：
3.2
通讯作者：
Lemerle, Jean
中科院分区：
文献类型：
--
作者：
Harif, Mhamed;Barsaoui, Sihem;Lemerle, Jean
背景。法国非洲儿科肿瘤小组（GFAOP）成立于2000年10月，目的是提高非洲癌症儿童的护理质量。来自阿尔及利亚、喀麦隆、马达加斯加、摩洛哥、突尼斯和塞内加尔的8个儿科肿瘤科已经参与其中。方法。年龄小于18岁且经细胞学或组织学证实为b细胞非霍奇金淋巴瘤的患者被纳入研究。提出了两种LMB89改良方案（MAT和GEM）。结果。由二一年四月至二四年四月，共登记了343宗个案。37例患者被排除在外。I期13例，II期26例，III期209例，IV期50例，其中L3急性淋巴细胞白血病（ALL3） 8例。3年总生存率为61%。GFA组36个月的OS为63.6%，I/II期为51.6%，III期为35.8%，IV期为35.8%。MAT组I/II期OS为84.4%，III期为76.2%，IV期为55.6%。71例患者在治疗期间死亡，32例在诱导前期，27例在诱导期，12例在巩固期。在3年的纳入期内，治疗相关死亡率下降（第一年：25.7%，第二年：19.1%，第三年：11.6%）。支持性护理的改善转化为总生存率从第一年的54%提高到第三年的73%。结论。这些数据证明了在非洲进行前瞻性多中心研究的可行性。在最初的三年里，人们注意到护理质量有所改善。
Background. The French African Paediatric Oncology Group (GFAOP) was set up in October 2000 to improve the quality of care of children with cancer in Africa. Eight pediatric oncology units from Algeria, Cameroon, Madagascar, Morocco, Tunisia, and Senegal have been involved. Methods. Patients less than 18 years with cytology or histology proven B-cell non-Hodgkin lymphoma were included. Two LMB89 modified regimens were proposed (MAT and GEM. Results. From April 2001 to April 2004, 343 cases were registered. Thirty seven patients were excluded. Thirteen patients were stage I, 26 stage II, 209 stage III and 50 stage IV including 8 L3 acute lymphoblastic leukemia (ALL3) cases. Three year OS of the whole population of patients is 61%. In GFA group 36 months OS is 63.6%, in stages I/II, 51.6% in stage III and 35.8% in stage IV. In MAT group, the OS is 84.4% in stages I/II, 76.2% in stage III and 55.6% in stage IV. Seventy one patients died during treatment, 32 at preinduction phase, 27 at induction and 12 at consolidation. Treatment related mortality decreased during the 3-year inclusion period (first year: 25.7%, second year: 19.1%, third year: 11.6%). The improvement of supportive care translated into an increase of the overall Survival rates from 54% in the first year to 73% in the third year. Conclusion. These data demonstrate the feasibility of prospective multicentric studies in Africa. An improvement of quality of care has been noticed during the 3 first years.