Skip Navigation LinksHome > July 2014 - Volume 36 - Issue 5 > Therapy of Advanced-stage Mature B-cell Lymphoma and Leukemi...
Journal of Pediatric Hematology/Oncology:
doi: 10.1097/MPH.0b013e31829d4900
Clinical and Laboratory Observations

Therapy of Advanced-stage Mature B-cell Lymphoma and Leukemia in Children and Adolescents With Rituximab and Reduced Intensity Induction Chemotherapy (B-NHL 2004M Protocol): The Results of a Multicenter Study

Samochatova, Elena V. MD, PhD*; Maschan, Alexey A. MD, PhD*; Shelikhova, Larisa N. MD*,†; Myakova, Natalia V. MD*,†; Belogurova, Margarita B. MD, PhD; Khlebnikova, Olga P. MD§; Shamardina, Anastasia V. MD; Ryskal, Olga V. MD; Roumiantseva, Julia V. MD*; Konovalov, Dmitriy M. MD*; Dubrovina, Maria E. MD; Rumyantsev, Alexander G. MD, PhD*

Collapse Box

Abstract

Pediatric mature B-cell non-Hodgkin lymphomas (B-NHLs) are highly aggressive malignant tumors that are curable with chemotherapy (ChT). High-dose methotrexate (MTX) is considered indispensable for successful treatment, but this therapy frequently induces severe mucositis and infectious complications, especially in induction, which can cause treatment failure. A prospective multicenter trial of combined immunochemotherapy for advanced-stage B-NHL with rituximab and the modified NHL-BFM-90 protocol was conducted. The major differences from the original protocol were a decrease in the dose of MTX from 5000 to 1000 mg/m2/24 h in the first 2 ChT blocks and the addition of rituximab at 375 mg/m2 to each of the first 4 blocks of ChT. Eighty-three newly diagnosed patients with a median age of 8.84 years with Burkitt lymphoma/leukemia and diffuse large B-cell lymphomas stage III to IV were included. Four patients died during induction ChT due to tumor lysis syndrome and infection. Two additional patients died subsequently due to tumor resistance. Complete remission was achieved in 77 (92.8%) patients; 2 patients relapsed at 1 and 3 months, and 2 developed secondary malignancies at 1 and 6.5 years, respectively, after the completion of therapy. The overall survival probability was 82%±8% with a median follow-up of 65.2 months. Combined therapy with rituximab and intensive ChT with a reduced MTX dose of 1 g/m2 in the 2 induction courses was feasible and produced high cure rates in patients with pediatric advanced-stage mature B-NHL.

Copyright © 2013 by Lippincott Williams & Wilkins

Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.

Connect With Us

Twitter
twitter.com/JPHOonline

For additional oncology content, visit LWW Oncology Journals on Facebook.