Impact of intensified maintenance therapy on the prognosis of children and adolescents with advanced lymphoblastic lymphoma
10.3760/cma.j.issn.0253-2727.2017.09.009
- VernacularTitle: 提高维持治疗强度对Ⅲ期和Ⅳ期儿童青少年淋巴母细胞淋巴瘤患者预后的影响
- Author:
Kaibin YANG
1
,
2
;
Xiaofei SUN
;
Zijun ZHEN
;
Suying LU
;
Jia ZHU
;
Feifei SUN
;
Juan WANG
;
Junting HUANG
;
Rirong CHEN
;
Litong YE
;
Ying LIU
;
Zhiyao YOU
Author Information
1. State Key Laboratory of Oncology in Southern China
2. Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
- Publication Type:Journal Article
- Keywords:
Precursor cell lymphoblastic leukemia-lymphoma;
Children;
Adolescent;
Maintenance chemotherapy;
Prognosis
- From:
Chinese Journal of Hematology
2017;38(9):778-783
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of intensified maintenance therapy on the prognosis of children and adolescents with advanced lymphoblastic lymphoma (LBL) .
Methods:Retrospective analysis on the treatment results of children and adolescents with stage Ⅲ and stage Ⅳ LBL who underwent BFM-NHL-90/-95 regimen without prophylactic radiotherapy. The intensified therapy group included the patients admitted from 1998 to 2005, while others were classified as the non-intensified therapy group. Patients in the intensified therapy group were intravenously treated with "etoposide phosphate plus cytrarabine" and high-dose methotrexate alternately per 2.5-3 months in addition to the oral chemotherapy with 6-mercaptopurine and methotrexate during the maintenance phase.
Results:A total of 187 LBL patients were enrolled. The rates of 5-year event free survival were (76.9 ± 5.8) % and (77.9 ± 4.3) % (χ2=0.249, P=0.617) respectively, in the intensified therapy (n=52) and the non-intensified therapy groups (n=135) , while the rates of 5-year overall survival of them were (78.8 ± 5.7) % and (79.8±4.1) % (χ2=0.353, P=0.552) , respectively. Stratified by stage, immunological type as well as risk stratification, the rates of long-term survival were similar between the two groups. During the maintenance phase, the rates of grade Ⅲ and Ⅳ myelosuppression in the intensified therapy and the non-intensified maintenance groups were 55.8% and 18.5%, respectively (χ2=25.363, P<0.05) .
Conclusion:Intensified maintenance therapy failed to improve the prognosis of patients with advanced LBL.
