title: Single-drug vinblastine as salvage treatment for refractory or relapsed anaplastic large-cell lymphoma: a report from the French Society of Pediatric Oncology.
abstract: OBJECTIVE
  To evaluate the efficacy of vinblastine for relapsed/refractory anaplastic large-cell lymphoma (ALCL).
  
  
  METHODS
  Data were reviewed on all 36 patients included prospectively in the French database for pediatric ALCL who were treated with vinblastine (6 mg/m(2)/wk) for resistant primary disease (one), a first relapse (15), or subsequent relapses (20). Fifteen patients had undergone hematopoietic stem-cell transplantation (HSCT) for a previous relapse.
  
  
  RESULTS
  Six patients were not evaluable for response, 25 (83%) of 30 evaluable patients achieved a complete remission (CR), and five experienced progressive disease. Among the 31 patients who achieved a CR with vinblastine or before its initiation, six patients were treated with HSCT and 25 with vinblastine alone (median duration, 14 months). Overall, nine of 25 patients treated with vinblastine alone have remained in CR (median, 7 years since the end of treatment), and 16 patients have relapsed. Vinblastine was still efficient for subsequent relapses. With a median follow-up of 9.2 years, 12 patients have died (four as a result of toxicity after HSCT and eight as a result of disease), and 24 patients are alive (15 following treatment with single-agent vinblastine for the last event). Five-year overall survival is 65% (95% CI, 48% to 79%), and 5-year event-free survival is 30% (95% CI, 17% to 47%).
  
  
  CONCLUSIONS
  Vinblastine is highly efficient in relapsed ALCL and may produce durable remissions. The optimal treatment duration still has to be assessed. These results should be borne in mind when designing future phase II studies with the targeted therapies directed against anaplastic lymphoma kinase.
authors.affiliation: Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France. brugiere@igr.fr
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugières
authors.forename: Helene
authors.initials: H
authors.lastname: Pacquement
authors.forename: Marie-Cecile
authors.initials: MC
authors.lastname: Le Deley
authors.forename: Guy
authors.initials: G
authors.lastname: Leverger
authors.forename: Patrick
authors.initials: P
authors.lastname: Lutz
authors.forename: Catherine
authors.initials: C
authors.lastname: Paillard
authors.forename: Andre
authors.initials: A
authors.lastname: Baruchel
authors.forename: Didier
authors.initials: D
authors.lastname: Frappaz
authors.forename: Brigitte
authors.initials: B
authors.lastname: Nelken
authors.forename: Laurence
authors.initials: L
authors.lastname: Lamant
authors.forename: Catherine
authors.initials: C
authors.lastname: Patte
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D014747:Vinblastine