Improved outcome in childhood B-cell lymphoma with the intensified French LMB protocol.
BACKGROUND
During the last 20 years, 120 children with B cell lymphoma were treated at the National Pediatric Hematology/Oncology Center of Israel. Until 1986, 63 patients received an institutional protocol (BMC), and thereafter 57 patients received a modified French LMB protocol. We report the results of a retrospective analysis comparing the results of these two protocols.


METHODS
Patient characteristics were similar in both groups except for stage of disease and lactate dehydrogenase (LDH) levels. Significantly more patients in the LMB group had higher stage disease, and the LDH levels also were higher (<600 microg/ml).


RESULTS
Fifty-four of fifty-seven children on the modified LMB protocol are alive, disease-free, with an overall event-free survival of 94% (median follow-up of 73 months). Event-free survival for stages I, II, and III patients is 100%, and for stage IV 77%, whereas the overall event-free survival was 58% among 63 children treated previously, and for stage IV patients only 10%. Severe marrow suppression and neutropenic enterocolitis were the major complications of this intensive protocol.


CONCLUSIONS
Intensive chemotherapy with a modified LMB protocol and modern supportive care result in a high cure rate of childhood B cell lymphoma even in patients with advanced disease.
Yaniv
I
I
Institute of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Beilinson Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Israel.
Fischer
S
S
Mor
C
C
Stark
B
B
Goshen
Y
Y
Stein
J
J
Cohen
I J
IJ
Zaizov
R
R
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D003561:Cytarabine; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D008727:Methotrexate