Intensified, sort duration chemotherapy of pediatric non-Hodgkin’s lymphoma

Abstract

8560 Background: The non-Hodgkin’s Lymphomas (NHL) in childhood are of diffuse histology and are characterized by wide dissemination and rapid progression. Methods: We describe here the result of MCP 842 Protocol is a series of patient treated at the Netaji Subhash Chandra Bose Cancer treatment & Research Institute between June 1996 and November 2004. Patient less than 25 yrs of age with a diagnosis of NHL and no prior treatment were eligible for the study. All patients had complete haematological and biochemical assessment including renal and hepatic function test, chest x-ray, abdominal ultra sound, bone marrow, biopsy and cerebrospinal fluid examination. A computerized tomography scan of primary site was performed to determine the extent of local disease. Pleural and ascetic fluids, if present, were examined for the presence of malignant cells. Patients are clinically stage according to the St. Jude’s (Murphy’s) classification. Patients with > 25% blasts in the bone marrow were treated as leukemia and excluded from the patient study. Response was assessed at the completion of 2 cycles of chemotherapy (1 each of A and B). Results: Complete response (CR) was defined as the absence of demonstrable tumor of clinical examination, supplemented by radiological examination of the original sites of disease. Partial response (PR) was defined as a reduction greater than 50% (Products of the widest diameters) in the volume of all measurable disease. A total of 75 previously untreated patients were entered on study. The age range was 2 to 25yrs (median 11). 36 patients had Lymphoblastic Lymphoma (LL), 15 diffuse Large B Cell Lymphoma (DLCL) and 22 of undifferentiated lymphoma (UD). The abdomen was the most common site of involvement followed by the mediastinum. 71 (95%) patients achieved complete response after 2 cycles of therapy 5(7.5%) achieved partial response and two had no response, 4 were not evaluable. A total of 20 patients (12 LL, 2 DLCL and 6 UDP) have died. The causes of death were progressive disease in 13, infection in 4, hepatitis in 2, and unknown 1.55 patients are alive and in complete remission. Conclusions: The results of protocol NCP 842 are promising. No significant financial relationships to disclose.