Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen

I. Magrath, M. Adde, A. Shad, D. Venzon, N. Seibel, J. Gootenberg, J. Neely, Carola A.S. Arndt, M. Nieder, E. Jaffe, R. A. Wittes, I. D. Horak

Research output: Contribution to journalArticle

332 Scopus citations

Abstract

Purpose: We have used identical treatment protocols for adults and children with small non-cleaved-cell lymphoma (SNCL) for many years and report here the results of two successive treatment regimens in these age groups. Patients and Methods: Seventy-two patients (39 adults and 33 children) were treated with protocol 7704 between 1977 and 1985. All patients, except those with resected abdominal disease, received 15 cycles of a combination of cyclophosphamide (CTX), doxorubicin (ADR), prednisone (PRED), vincristine (VCR), high-dose methotrexate (MTX), and intrathecal (IT) therapy. Forty-one patients (20 adults and 21 children) were treated with protocol 89-C-41, which has been used since 1989. High-risk patients received four alternating cycles (with a total duration of 12 to 15 weeks) of an intensified version of protocol 77-04 without PRED (CODOX-M), and a new drug combination consisting of ifosfamide, etoposide, high-dose cytarabine (ara- C), and IT MTX (IVAC). Low-risk patients received three cycles of the CODOX- M regimen. High-risk patients were randomized to either receive or not receive granulocyte-macrophage colony-stimulating factor (GM-CSF). Results: Event-free survival (EFS) in protocol 77-04 was 56% at 2 years and beyond. EFS in protocol 89-C-41 was 92% at 2 years and beyond. GM-CSF was associated with increased thrombocytopenia. Conclusion: Adults and children with SNCL have a similar prognosis when treated with the same chemotherapy. EFS in high-risk patients has been markedly improved by including IVAC in protocol 89-C-41, and excellent results can be achieved with only four cycles of therapy. In protocol 89-C-41, GM-CSF was not beneficial.

Original languageEnglish (US)
Pages (from-to)925-934
Number of pages10
JournalJournal of Clinical Oncology
Volume14
Issue number3
StatePublished - Mar 1996
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

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    Magrath, I., Adde, M., Shad, A., Venzon, D., Seibel, N., Gootenberg, J., Neely, J., Arndt, C. A. S., Nieder, M., Jaffe, E., Wittes, R. A., & Horak, I. D. (1996). Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. Journal of Clinical Oncology, 14(3), 925-934.