PURPOSE: The widely used, risk-based Lymphome Malin de Burkitt (LMB) chemotherapy regimen has improved survival rates for children with mature B-cell non-Hodgkin lymphoma (NHL); however, associated late effects remain understudied. We assessed late health outcomes after LMB treatment in the Childhood Cancer Survivor Study. PATIENTS AND METHODS: Multivariable regression models compared chronic health conditions, health status, and socioeconomic and neurocognitive outcomes between survivors of NHL treated with the LMB regimen (n = 126), survivors of NHL treated with non-LMB regimens (n = 444), and siblings (n = 1,029). RESULTS: LMB survivors were a median age of 10.2 years (range, 2.5 to 20.5 years) at diagnosis and 24.0 years (range, 10.3 to 35.3 years) at evaluation. Compared with siblings, LMB survivors were at increased risk for adverse health outcomes. However, survivors of NHL treated with LMB and non-LMB regimens did not differ with regard to risk of having any chronic health conditions, impaired health status, neurocognitive deficits, or poorer socioeconomic outcomes. Increased risk for the following specific neurologic conditions was observed in LMB survivors compared with non-LMB survivors: epilepsy (relative risk [RR], 15.2; 95% CI, 3.1 to 73.4); balance problems (RR, 8.9; 95% CI, 2.3 to 34.8); tremors (RR, 7.5; 95% CI, 1.9 to 29.9); weakness in legs (RR, 8.1; 95% CI, 2.5 to 26.4); severe headaches (RR, 3.2; 95% CI, 1.6 to 6.3); and prolonged arm, leg, or back pain (RR, 4.0; 95% CI, 2.2 to 7.1). The survivors from the group C LMB risk group (n = 50) were at the highest risk for these conditions; however, except for worse functional status (odds ratio, 2.7; 95% CI, 1.2 to 5.8), they were not at increased risk for other adverse health status or socioeconomic outcomes compared with non-LMB survivors. CONCLUSION: Survivors treated with LMB and non-LMB regimens are largely comparable in late health outcomes except for excess neurotoxicity among LMB survivors. These data inform treatment efforts seeking to optimize disease control while minimizing toxicity.
PURPOSE: The widely used, risk-based Lymphome Malin de Burkitt (LMB) chemotherapy regimen has improved survival rates for children with mature B-cell non-Hodgkin lymphoma (NHL); however, associated late effects remain understudied. We assessed late health outcomes after LMB treatment in the Childhood Cancer Survivor Study. PATIENTS AND METHODS: Multivariable regression models compared chronic health conditions, health status, and socioeconomic and neurocognitive outcomes between survivors of NHL treated with the LMB regimen (n = 126), survivors of NHL treated with non-LMB regimens (n = 444), and siblings (n = 1,029). RESULTS:LMB survivors were a median age of 10.2 years (range, 2.5 to 20.5 years) at diagnosis and 24.0 years (range, 10.3 to 35.3 years) at evaluation. Compared with siblings, LMB survivors were at increased risk for adverse health outcomes. However, survivors of NHL treated with LMB and non-LMB regimens did not differ with regard to risk of having any chronic health conditions, impaired health status, neurocognitive deficits, or poorer socioeconomic outcomes. Increased risk for the following specific neurologic conditions was observed in LMB survivors compared with non-LMB survivors: epilepsy (relative risk [RR], 15.2; 95% CI, 3.1 to 73.4); balance problems (RR, 8.9; 95% CI, 2.3 to 34.8); tremors (RR, 7.5; 95% CI, 1.9 to 29.9); weakness in legs (RR, 8.1; 95% CI, 2.5 to 26.4); severe headaches (RR, 3.2; 95% CI, 1.6 to 6.3); and prolonged arm, leg, or back pain (RR, 4.0; 95% CI, 2.2 to 7.1). The survivors from the group C LMB risk group (n = 50) were at the highest risk for these conditions; however, except for worse functional status (odds ratio, 2.7; 95% CI, 1.2 to 5.8), they were not at increased risk for other adverse health status or socioeconomic outcomes compared with non-LMB survivors. CONCLUSION: Survivors treated with LMB and non-LMB regimens are largely comparable in late health outcomes except for excess neurotoxicity among LMB survivors. These data inform treatment efforts seeking to optimize disease control while minimizing toxicity.
Authors: Wendy M Leisenring; Ann C Mertens; Gregory T Armstrong; Marilyn A Stovall; Joseph P Neglia; Jennifer Q Lanctot; John D Boice; John A Whitton; Yutaka Yasui Journal: J Clin Oncol Date: 2009-04-13 Impact factor: 44.544
Authors: Kevin R Krull; Gerard Gioia; Kirsten K Ness; Leah Ellenberg; Christopher Recklitis; Wendy Leisenring; Sujuan Huang; Marilyn Stovall; Leslie L Robison; Lonnie Zeltzer Journal: Cancer Date: 2008-10-15 Impact factor: 6.860
Authors: Melissa M Hudson; Kevin C Oeffinger; Kendra Jones; Tara M Brinkman; Kevin R Krull; Daniel A Mulrooney; Ann Mertens; Sharon M Castellino; Jacqueline Casillas; James G Gurney; Paul C Nathan; Wendy Leisenring; Leslie L Robison; Kirsten K Ness Journal: J Clin Oncol Date: 2014-12-29 Impact factor: 44.544
Authors: Mary Gerrard; Ian M Waxman; Richard Sposto; Anne Auperin; Sherrie L Perkins; Stanton Goldman; Lauren Harrison; Ross Pinkerton; Keith McCarthy; Martine Raphael; Catherine Patte; Mitchell S Cairo Journal: Blood Date: 2012-11-13 Impact factor: 22.113
Authors: A Reiter; M Tiemann; W D Ludwig; H H Wacker; E Yakisan; M Schrappe; D Henzler; K W Sykora; A Brandt; E Odenwald Journal: Klin Padiatr Date: 1994 Jul-Aug Impact factor: 1.349
Authors: C Patte; T Philip; C Rodary; A Bernard; J M Zucker; J L Bernard; A Robert; X Rialland; E Benz-Lemoine; F Demeocq Journal: J Clin Oncol Date: 1986-08 Impact factor: 44.544
Authors: Gregory T Armstrong; Yan Chen; Yutaka Yasui; Wendy Leisenring; Todd M Gibson; Ann C Mertens; Marilyn Stovall; Kevin C Oeffinger; Smita Bhatia; Kevin R Krull; Paul C Nathan; Joseph P Neglia; Daniel M Green; Melissa M Hudson; Leslie L Robison Journal: N Engl J Med Date: 2016-01-13 Impact factor: 91.245
Authors: Leslie L Robison; Ann C Mertens; John D Boice; Norman E Breslow; Sarah S Donaldson; Daniel M Green; Frederic P Li; Anna T Meadows; John J Mulvihill; Joseph P Neglia; Mark E Nesbit; Roger J Packer; John D Potter; Charles A Sklar; Malcolm A Smith; Marilyn Stovall; Louise C Strong; Yutaka Yasui; Lonnie K Zeltzer Journal: Med Pediatr Oncol Date: 2002-04
Authors: Andishe Attarbaschi; Elisa Carraro; Leila Ronceray; Mara Andrés; Shlomit Barzilai-Birenboim; Simon Bomken; Laurence Brugières; Birgit Burkhardt; Francesco Ceppi; Alan K S Chiang; Monika Csoka; Alina Fedorova; Janez Jazbec; Edita Kabickova; Jan Loeffen; Karin Mellgren; Natalia Miakova; Olga Moser; Tomoo Osumi; Apostolos Pourtsidis; Charlotte Rigaud; Anne Uyttebroeck; Wilhelm Woessmann; Marta Pillon Journal: Leukemia Date: 2020-05-11 Impact factor: 11.528
Authors: Krista Ocier; Sarah Abdelaziz; Seungmin Kim; Kerry Rowe; John Snyder; Vikrant Deshmukh; Michael Newman; Alison Fraser; Ken Smith; Christina A Porucznik; Kimberley Shoaf; Joseph B Stanford; Catherine J Lee; Mia Hashibe Journal: Cancer Med Date: 2021-05-12 Impact factor: 4.452
Authors: Olga Moser; Martin Zimmermann; Ulrike Meyer; Wolfram Klapper; Ilske Oschlies; Martin Schrappe; Andishe Attarbaschi; Georg Mann; Felix Niggli; Claudia Spix; Udo Kontny; Thomas Klingebiel; Alfred Reiter; Birgit Burkhardt; Wilhelm Woessmann Journal: Haematologica Date: 2021-05-01 Impact factor: 9.941