Document Detail


Relapses of childhood anaplastic large-cell lymphoma: treatment results in a series of 41 children--a report from the French Society of Pediatric Oncology.
MedLine Citation:
PMID:  10690387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To study response to chemotherapy and the outcome of children treated for a relapsed anaplastic large-cell lymphoma (ALCL) and to evaluate the role of bone marrow transplantation (BMT) in these patients. PATIENTS AND METHODS: Clinical data concerning the 41 relapses that occurred in 119 patients with ALCL enrolled in 3 consecutive studies since 1975 were analysed. First-line treatment consisted of intensive chemotherapy according to the COPAD protocol for the first series of 12 patients treated between 1975 and 1989 and to the SFOP (French Society of Pediatric Oncology) HM protocols for the 30 patients treated between 1989 and 1997. Twenty-eight patients were treated with CV(B)A (CCNU, vinblastine, ara-C with or without bleomycin), and the others with miscellaneous protocols for recurrent disease. Fifteen patients underwent autologous BMT and 1 allogeneic BMT while in CR2. RESULTS: Thirty-six of forty-one (88%) patients achieved CR2. With a median follow-up of 5 years, 12 patients died, 9 of their disease and 29 patients are alive in CR2 (20 patients), CR3 (5 patients), CR4 (2 patients), CR5 (1 patient) or CR6 (1 patient). Overall and disease-free survival are respectively 69% (53%-82%) and 44% (29%-61%) at three years. In univariate analysis, patients treated with ABMT while in CR2 did not appear to have a better outcome than the other. Remarkably, a long-lasting remission was obtained in 8 of 13 patients treated with weekly vinblastine for a relapse including 6 relapses occurring after ABMT. CONCLUSIONS: Relapsed ALCL are highly chemosensitive but over 40% of the patients experience several relapses. Prolonged conventional chemotherapy based on vinblastine might, in some cases, be as efficient as short intensive treatment with ABMT.
Authors:
L Brugières; P Quartier; M C Le Deley; H Pacquement; Y Perel; C Bergeron; C Schmitt; J Landmann; C Patte; M J Terrier-Lacombe; G Delsol; O Hartmann
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  11     ISSN:  0923-7534     ISO Abbreviation:  Ann. Oncol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-14     Completed Date:  2000-03-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  IM    
Affiliation:
Department of Pediatric Oncology, Institut Gustave-Roussy, Villejuif, France. brugiere@igr.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Asparaginase / administration & dosage
Bleomycin / administration & dosage
Bone Marrow Transplantation*
Child
Child, Preschool
Cyclophosphamide / administration & dosage
Cytarabine / administration & dosage
Disease-Free Survival
Doxorubicin / administration & dosage
Female
Follow-Up Studies
France
Humans
Infant
Lomustine / administration & dosage
Lymphoma, Large B-Cell, Diffuse / drug therapy,  mortality,  pathology,  therapy*
Male
Methotrexate / administration & dosage
Prednisone / administration & dosage
Recurrence
Retrospective Studies
Survival Rate
Transplantation, Autologous
Transplantation, Homologous
Vinblastine / administration & dosage
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/COPAD protocol; 11056-06-7/Bleomycin; 13010-47-4/Lomustine; 147-94-4/Cytarabine; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 57-22-7/Vincristine; 59-05-2/Methotrexate; 865-21-4/Vinblastine; EC 3.5.1.1/Asparaginase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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