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M9550232.TXT
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1995-03-04
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Document 0232
DOCN M9550232
TI Small noncleaved cell lymphoma and leukemia in adults. A retrospective
study of 65 adults treated with the LMB pediatric protocols.
DT 9505
AU Soussain C; Patte C; Ostronoff M; Delmer A; Rigal-Huguet F; Cambier N;
Leprise PY; Francois S; Cony-Makhoul P; Harousseau JL; et al; Institut
Gustave Roussy, Villejuif, France.
SO Blood. 1995 Feb 1;85(3):664-74. Unique Identifier : AIDSLINE
MED/95134897
AB In France, more than 80% of children with Burkitt's lymphoma or
Burkitt's leukemia (ALL3) are now cured with the LMB (B-cell
non-Hodgkin's lymphoma and B-ALL) protocols of the Societe Francaise
d'Oncologie Pediatrique, but so far, poor results have been obtained in
the few adult studies available. We have analyzed the experience with
LMB protocols in adult patients. This retrospective study involved 65
adult patients with small noncleaved cell lymphoma or ALL3 treated with
the LMB protocols. They were 17 to 65 years old and not previously
treated. Human immunodeficiency virus-infected patients were excluded.
The diagnoses were made between September 1984 and August 1991.
According to the Murphy classification, 12 patients (18%) had stage I or
II disease, 25 (38%), stage III disease; 4 (6%), stage IV disease; and
24 (37%), ALL3 (> or = 25% blasts). According to the Ann Arbor
classification, 9 patients had stage I disease; 8 patients, stage II; 5
patients, stage III; 21 patients, stage IV disease; and 22 patients, ALL
(> or = 30% blasts). Twelve patients had central nervous system (CNS)
involvement before treatment. Thirty-nine patients were treated
according to the LMB 84 protocol scheme; 14 according to the LMB 86
protocol, and 12 patients received the LMB 84 induction courses followed
by the LMB 86 consolidation courses. Three patients underwent bone
marrow transplantation (BMT) while in second complete remission (CR) and
3 others had refractory disease. There were some protocol violations
caused by empirical medical decisions: local irradiation was performed
in 4 patients, 2 patients received prophylactic radiation to the brain
that was not specified in the protocol, 13 patients underwent BMT in
first CR, and methotrexate doses were modified in 10 patients.
Fifty-eight patients (89%) achieved a CR. There were four (6%) primary
induction treatment failures, and three (4%) early treatment-related
deaths. Eight patients relapsed between 2 and 30 months after CR
(median, 4.7 months). Forty-seven patients are alive in CR (45 first CR,
2 second CR) with a median follow-up of 57 months (24 to 93 months).
There were five toxicity-related deaths among patients in CR including
four BMT-related deaths and five deaths caused by refractory relapses.
One patient died in CR at 62 months of rectal cancer. The 3-year overall
survival rate is 74% (SE = 5). According to the stages in the Murphy
classification, the 3-year survival rates are stages I and II, 100%;
stage III, 80% (SE = 7); and stage IV and ALL, 57% (SE = 8). Seven of 12
patients with initial CNS disease are alive with a median survival of 56
months.(ABSTRACT TRUNCATED AT 400 WORDS)
DE Adolescence Aged Antineoplastic Agents, Combined/*THERAPEUTIC USE
Bone Marrow Transplantation Child Cyclophosphamide/ADMINISTRATION &
DOSAGE Cytarabine/ADMINISTRATION & DOSAGE Female Human Leukemia,
Lymphocytic, Acute/*DRUG THERAPY/MORTALITY/PATHOLOGY/ THERAPY
Lymphoma, Small Noncleaved-Cell/*DRUG THERAPY/MORTALITY/PATHOLOGY/
THERAPY Male Methotrexate/ADMINISTRATION & DOSAGE Middle Age
Neoplasm Staging Pregnancy Prognosis Retrospective Studies Survival
Rate Treatment Outcome JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).