ISSN:
1569-8041
Keywords:
ABMT
;
anaplastic large-cell lymphoma
;
children
;
relapse
;
vinblastine
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Purpose:to study response to chemotherapy and the outcome ofchildren treated for a relapsed anaplastic large-cell lymphoma (ALCL) and toevaluate the role of bone marrow transplantation (BMT) in these patients. Patients and methods:Clinical data concerning the 41 relapsesthat occurred in 119 patients with ALCL enrolled in 3 consecutive studiessince 1975 were analysed. First-line treatment consisted of intensivechemotherapy according to the COPAD protocol for the first series of 12patients treated between 1975 and 1989 and to the SFOP (French Society ofPediatric Oncology) HM protocols for the 30 patients treated between 1989 and1997. Twenty-eight patients were treated with CV(B)A (CCNU, vinblastine, ara-Cwith or without bleomycin), and the others with miscellaneous protocols forrecurrent disease. Fifteen patients underwent autologous BMT and 1 allogeneicBMT while in CR2. Results:Thirty-six of forty-one (88%) patients achievedCR2. With a median follow-up of 5 years, 12 patients died, 9 of their diseaseand 29 patients are alive in CR2 (20 patients), CR3 (5 patients), CR4 (2patients), CR5 (1 patient) or CR6 (1 patient). Overall and disease-freesurvival are respectively 69% (53%–82%) and44% (29%–61%) at three years. In univariateanalysis, patients treated with ABMT while in CR2 did not appear to have abetter outcome than the other. Remarkably, a long-lasting remission wasobtained in 8 of 13 patients treated with weekly vinblastine for a relapseincluding 6 relapses occurring after ABMT. Conclusions:Relapsed ALCL are highly chemosensitive but over40% of the patients experience several relapses. Prolonged conventionalchemotherapy based on vinblastine might, in some cases, be as efficient asshort intensive treatment with ABMT.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008352726155
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