TY - JOUR
T1 - Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen
AU - Magrath, I.
AU - Adde, M.
AU - Shad, A.
AU - Venzon, D.
AU - Seibel, N.
AU - Gootenberg, J.
AU - Neely, J.
AU - Arndt, C.
AU - Nieder, M.
AU - Jaffe, E.
AU - Wittes, R. A.
AU - Horak, I. D.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1996/3
Y1 - 1996/3
N2 - 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.
AB - 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.
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U2 - 10.1200/JCO.1996.14.3.925
DO - 10.1200/JCO.1996.14.3.925
M3 - Article
C2 - 8622041
AN - SCOPUS:9044226138
SN - 0732-183X
VL - 14
SP - 925
EP - 934
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 3
ER -