PURPOSE: In an effort to improve outcome for children with advanced B-cell malignancies, a treatment plan based on a published regimen that consists of four courses of fractionated cyclophosphamide (cyclo) given with doxorubicin (doxo) and vincristine (VCR) was intensified by alternating with sequential high-dose methotrexate (MTX) and cytarabine (Ara-C), given in conjunction with intrathecal (IT) MTX and Ara-C. PATIENTS AND METHODS: From October 1986 to October 1992, 133 eligible patients were enrolled: 74 with B-cell (surface immunoglobulin-positive [Slg+] acute lymphoblastic leukemia (B-ALL) and 59 with stage IV small noncleaved-cell lymphoma (SNCCL). The median age was 8 years; there were 103 males and 30 females. Abdominal tumor masses were prominent in 63 cases (33 B-ALL and 30 stage IV SNCCL). RESULTS: Complete remission (CR) was achieved in 66 B-ALL and 57 stage IV patients (93% overall). At 4 years, the estimated event-free survival (EFS) rate is 65% +/- 8% for patients with B-ALL and 79% +/- 9% for those with stage IV SNCCL. Among patients with CNS involvement, 23 of 36 remain in CR (4-year EFS rate, 64% +/- 13%). Relapses occurred early; only 3 patients relapsed after completion of therapy. Thirteen relapses occurred in the marrow, three in the CNS, and six in other sites. Of 11 CNS-positive patients who relapsed, only two recurred primarily in the CNS. CONCLUSION: The results of this study indicate that with intensified chemotherapy an increasing potential for cure exists for patients with B-ALL and stage IV SNCCL.
PURPOSE: In an effort to improve outcome for children with advanced B-cell malignancies, a treatment plan based on a published regimen that consists of four courses of fractionated cyclophosphamide (cyclo) given with doxorubicin (doxo) and vincristine (VCR) was intensified by alternating with sequential high-dose methotrexate (MTX) and cytarabine (Ara-C), given in conjunction with intrathecal (IT) MTX and Ara-C. PATIENTS AND METHODS: From October 1986 to October 1992, 133 eligible patients were enrolled: 74 with B-cell (surface immunoglobulin-positive [Slg+] acute lymphoblastic leukemia (B-ALL) and 59 with stage IV small noncleaved-cell lymphoma (SNCCL). The median age was 8 years; there were 103 males and 30 females. Abdominal tumor masses were prominent in 63 cases (33 B-ALL and 30 stage IV SNCCL). RESULTS: Complete remission (CR) was achieved in 66 B-ALL and 57 stage IV patients (93% overall). At 4 years, the estimated event-free survival (EFS) rate is 65% +/- 8% for patients with B-ALL and 79% +/- 9% for those with stage IV SNCCL. Among patients with CNS involvement, 23 of 36 remain in CR (4-year EFS rate, 64% +/- 13%). Relapses occurred early; only 3 patients relapsed after completion of therapy. Thirteen relapses occurred in the marrow, three in the CNS, and six in other sites. Of 11 CNS-positive patients who relapsed, only two recurred primarily in the CNS. CONCLUSION: The results of this study indicate that with intensified chemotherapy an increasing potential for cure exists for patients with B-ALL and stage IV SNCCL.
Authors: Mitchell S Cairo; Richard Sposto; Mary Gerrard; Anne Auperin; Stanton C Goldman; Lauren Harrison; Ross Pinkerton; Martine Raphael; Keith McCarthy; Sherrie L Perkins; Catherine Patte Journal: J Clin Oncol Date: 2012-01-03 Impact factor: 44.544
Authors: Melissa M Hudson; Joseph P Neglia; William G Woods; John T Sandlund; Ching-Hon Pui; Larry E Kun; Leslie L Robison; Daniel M Green Journal: Pediatr Blood Cancer Date: 2011-10-28 Impact factor: 3.167
Authors: Kristine R Crews; Yinmei Zhou; Jennifer L Pauley; Scott C Howard; Sima Jeha; Mary V Relling; Ching-Hon Pui Journal: Cancer Date: 2010-01-01 Impact factor: 6.860
Authors: Rosa Nguyen; Sima Jeha; Yinmei Zhou; Xueyuan Cao; Cheng Cheng; Deepa Bhojwani; Patrick Campbell; Scott C Howard; Jeffrey Rubnitz; Raul C Ribeiro; John T Sandlund; Tanja Gruber; Hiroto Inaba; Ching-Hon Pui; Monika L Metzger Journal: Pediatr Blood Cancer Date: 2016-05-17 Impact factor: 3.167
Authors: John T Sandlund; Victor M Santana; Melissa M Hudson; Mihaela Onciu; David Head; Daryl J Murry; Raul Ribeiro; Dana Wallace; Renee Rencher; Ching-Hon Pui Journal: Cancer Date: 2008-08-15 Impact factor: 6.860
Authors: A M Evens; K R Carson; J Kolesar; C Nabhan; I Helenowski; N Islam; B Jovanovic; P M Barr; P F Caimi; S A Gregory; L I Gordon Journal: Ann Oncol Date: 2013-10-20 Impact factor: 32.976