Journal
PEDIATRIC BLOOD & CANCER
Volume 43, Issue 5, Pages 580-586Publisher
WILEY
DOI: 10.1002/pbc.20116
Keywords
chemotherapy; childhood cancer; LMB-89 protocol; non-Hodgkins lymphoma
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Background. We analyzed the results of the LMB-89 protocol performed in seven centers in Venezuela in 96 children having B-cell nonHodgkin lymphoma treated from 1995 to 2002. Procedure. Mean age was 7.1 years with 71 (74%) been male. Eighty-two patients (85%) had diffuse small cell lymphoma Burkitt and Burkitt-like, and 14 (15%) had diffuse large B-cell lymphoma. Initial disease sites included the abdomen in 67%, peripheral nodes in 8%, and mediastinal in 4%. Treatment was directed to risk groups as described for LMB-89 protocol. Group A: seven patients (7%), group B: 80 patients (83%), and group C: nine patients (9%). Results. Mean follow-up was 35+/-31 months. Complete remission (CR) occurred in 70 patients (73%); four patients (6%) had relapse during the first year and ten patients (10%) had progressive disease. Overall survival (OS) and event free survival (EFS) were 85 and 80% at 1 year, and 82 and 75% at 2 years, respectively. The EFS by therapeutic groups at 3 years was A: 100%; B: 76%, and C: 56%. Toxicity: neutropenia in 75%, thrombocytopenia in 63%, febrile neutropenia in 39%. Viral infections: hepatitis B in 20%, hepatitis C in 2%, and Herpes zoster in 3%. Tumor lysis syndrome (TLS) occurred in 9% during induction phase with a high mortality of 44% (urate-oxidase was available only at the end of the study). Conclusions. The high mortality rate during induction phase prohibited a better EFS. Prophylactic use of xantine-oxidase may improve future results. The high incidence of hepatitis B requires a vaccination program. (C) 2004 Wiley-Liss, Inc.
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