[High-dose chemotherapy in the treatment of children with malignant lymphoma].
BACKGROUND
Children with primary refractory or recurrent malignant lymphoma have usually poor prognosis. Less than 10% of those, who were treated with conventional-dose regimens had survived for 2 years. In an attempt to improve the outcome for these patients, we explored the role of consolidation high-dose chemotherapy with autografting.


RESULTS
Forty-five patients with poor-prognosis lymphoma, of whom 27 were males, underwent megatherapy between January 1992 and December 1999. High-dose chemotherapy was indicated in patients with poor initial response to first-line chemotherapy (14 cases) or in the relapse (31 cases). The group consisted of 27 patients with Hodgkin's disease and 18 patients with non-Hodgkin's lymphoma. The median age was 14.7 years. The conditioning for Hodgkin's disease patients contained cyclophosphamide, etoposide and busulfan or carmustine. Patients with non-Hodgkin's lymphomas received cyclophosphamide, etoposide and busulfan or total body irradiation. Bone marrow was used as the source of haemopoietic stem cells in ten patients, peripheral blood in twenty-eight, and both sources were used in seven patients. After the median follow-up of 47 months, the final survival was 61%. Eleven patients died of the disease progression, four of the infectious complications, one at a car accident. Median time to relapse after the transplantation was 7.5 months.


CONCLUSIONS
Further improvement of these results will require earlier transplantation, improved preparative regiments or early posttransplant immunotherapy.
Kabícková
E
E
Klinika dĕtské onkologie 2. LF UK a FNM, Praha.
Kavan
P
P
Koutecký
J
J
Malis
J
J
Stanková
J
J
Gajdos
P
P
Kodet
R
R
Cumlivská
E
E
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000188:drug therapy* / Q000628:therapy; D008297:Male; D015996:Survival Rate
Vysokodávkovaná chemoterapie v lécbĕ dĕtí s maligním lymfomem.