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- Title
Detection of prognostic factors in children and adolescents with Burkitt and Diffuse Large B-Cell Lymphoma treated with the AIEOP LNH-97 protocol.
- Authors
Pillon, Marta; Mussolin, Lara; Carraro, Elisa; Conter, Valentino; Aricò, Maurizio; Vinti, Luciana; Garaventa, Alberto; Piglione, Matilde; Buffardi, Salvatore; Sala, Alessandra; Santoro, Nicola; Lo Nigro, Luca; Mura, Rossella; Tondo, Annalisa; Casale, Fiorina; Farruggia, Piero; Pierani, Paolo; Cesaro, Simone; d'Amore, Emanuele S. G.; Basso, Giuseppe
- Abstract
Burkitt lymphoma ( BL) and Diffuse Large B-Cell Lymphoma ( DLBCL) account for most cases of non-Hodgkin lymphoma ( NHL) in childhood. We report the clinical characteristics, outcome and prognostic factors in children with BL or DLBCL treated according to the Associazione Italiana Ematologia Oncologia Pediatrica ( AIEOP) LNH-97 protocol. Patients aged up to 18 years that were newly diagnosed with BL/ DLBCL were included in the study. Therapy consisted of pre-phase followed by 2-6 high-dose chemotherapy courses tailored according to lactate dehydrogenase ( LDH) value and disease stage. A total of 442 patients (379 BL, 63 DLBCL) were enrolled between 1997 and 2014, of whom 18 failed to achieve remission, 6 experienced treatment-related death, 2 developed second malignancy and 20 relapsed. At a median follow-up time of 5 years, overall survival was 93% (±1%) and event-free survival was 90% (±1%). LDH value above the median value had an independently negative prognostic value ( P < 0·0001). However, in the subgroup of 128 patients in which minimal disseminated disease ( MDD) was analysed, MDD-positivity became the only unfavourable prognostic factor for progression-free survival. Tailored chemotherapy could be extremely effective with limited toxicity. Identification of MDD as a hallmark of a higher risk of treatment failure may provide a target population for treatment intensification by anti- CD20.
- Subjects
BURKITT'S lymphoma; DIFFUSE large B-cell lymphomas; LYMPHOMAS; LYMPHOMAS in children; CANCER chemotherapy; CD20 antigen; MEDICAL protocols; PROGRESSION-free survival; THERAPEUTICS; PROGNOSIS
- Publication
British Journal of Haematology, 2016, Vol 175, Issue 3, p467
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.14240