title: Treatment of Childhood T-Cell Lymphoblastic Lymphoma-Long-Term Results of the SFOP LMT96 Trial.
abstract: OBJECTIVE
  Outcome of T-cell lymphoblastic lymphoma (T-LBL) in children is around 75-85% of event-free survival. The role of early intensification to improve outcome while using short infusions of high dose methotrexate (HDMTX) and shorter maintenance treatment was addressed by the French Society of Pediatric Oncology (SFOP) group.
  
  
  METHODS
  From 1997 through 2003, 79 children (52 males; median age 10.5 years) were prospectively registered into the SFOP LMT 96 trial. The LMT96 protocol, with elements from the protocol of the Berlin-Frankfurt-Münster (BFM) Group included four main modifications: (a) 10 courses of HD-MTX (3 g/m(2) ) delivered over the first 44 weeks; (b) early intensification with cyclophosphamide together with the first course of HD-MTX; (c) a maintenance phase that included 6 monthly intensified chemotherapy pulses; and (d) treatment duration of 18 months for stages I-III.
  
  
  RESULTS
  Eighty-nine percent of patients had an initial mediastinal involvement. With a median follow-up of 87 months, the 5-year event-free survival was 85% and overall survival 89%. Nine patients relapsed, eight during treatment. The early intensification did not change the pattern of relapses. Only 58% of patients experienced grade 3-4 neutropenia during the induction phase, 13% patients experienced grade 3 and 4 mucositis, and 5% patients experienced diabetes. The early intensification did not delay phases of chemotherapy.
  
  
  CONCLUSIONS
  Early intensification in treatment for T-LBL in children is manageable. Three-hour infusion of HD-MTX did not jeopardize patient outcome. Our results are comparable with those of other international protocols in spite of shorter maintenance treatment for stages I-III.
authors.affiliation: Department of Pediatric Oncology, IHOP, Centre Léon Bérard, Lyon, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Bergeron
authors.affiliation: Aix-Marseille University and Pediatric Department of APHM, Marseille, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Coze
authors.affiliation: Department of Statistics, Centre Léon Bérard, Lyon, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Segura
authors.affiliation: Department of Pediatric Oncology, Institut Curie, Paris, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Pacquement
authors.affiliation: Department of Pediatric, CHU de Rennes, Rennes, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Gandemer
authors.affiliation: Department of Pediatric, Bordeaux, CHU, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Ducassou
authors.affiliation: Department of Pediatric Oncology, Gustave Roussy, Villejuif, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Patte
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016399:Lymphoma, T-Cell / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D003520:Cyclophosphamide; D008727:Methotrexate
keywords: childhood; lymphoblastic malignancies; methotrexate; non-Hodgkin's lymphomas