Yang C P, Hung J J, Jaing T H, Lin K H, Lin D T, Lu M Y, Liang D C, Chen S H, Liu H C, Hsiao C C, Shu S G, Chen J S, Chang T T, Chiou S S, Hsieh Y L, Lin M T, Lee M T, Peng C T, Cheng S N, Chen R L, Chen B W, Lin K S
Division of Hemotology/Oncology, Chang-Gung Children's Hospital-Linkou, Taipei, Taiwan.
Acta Paediatr Taiwan. 2000 Jul-Aug;41(4):193-204.
A nation-wide chemotherapeutic trial for childhood non-Hodgkin's lymphoma (NHL) was conducted by the Taiwan Pediatric Oncology Group (TPOG). Four TPOG-NHL92 protocols based on stage and histology were activated in 1992: TPOG-92LD (treatment duration: 8 months) was used for localized (stages I/II) NHL with any histology, 92LB (2 years), 92SNC (5 months), and 92LC (1 year) for advanced (stages III/IV) lymphoblastic (LB), small non-cleaved cell (SNC), and large cell (LC) lymphoma, respectively. From January 1992 through June 1998, 200 children with newly diagnosed NHL from 13 member hospitals of TPOG were enrolled. There were 140 boys and 60 girls. Their ages at diagnosis ranged from 2.4 months to 18.3 years with a median of 8.2 years. There were 54 (27.3%) patients with LB, 94 (47.5%) with SNC including B-cell acute lymphoblastic leukemia (B-ALL), and 50 (25.2%) with LC. Stages I, II, III, and IV (including B-ALL) of the disease comprised 5%, 10%, 43%, and 42% of cases, respectively. There were 176 patients eligible for evaluation of treatment results. The remission rate of induction was 82.4%, induction failed in 22 (12.5%) patients, and nine patients died during induction. As of August 31, 1999, 26 patients relapsed, six died during remission, one patient developed secondary acute myelomonocytic leukemia, and 105 patients remained in continuous remission with a median remission duration of 49 months. The event-free survival (EFS) at 7 years was 63.5%, 61.5% and 65% for LB, SNC, and LC groups (P = 0.8298). The 7-year EFS for stages I/II, III, and IV of the disease was 73%, 68.9%, and 50.3% (P = 0.0212), respectively. We concluded that following the strategy of stratification of therapy, only disease stages had prognostic significance in this study. More efforts are needed to improve our treatment results.
台湾儿科肿瘤学组（TPOG）开展了一项针对儿童非霍奇金淋巴瘤（NHL）的全国性化疗试验。1992年启动了4种基于分期和组织学的TPOG-NHL92方案：TPOG-92LD（治疗周期：8个月）用于任何组织学类型的局限性（I/II期）NHL，92LB（2年）、92SNC（5个月）和92LC（1年）分别用于晚期（III/IV期）淋巴细胞性（LB）、小无裂细胞性（SNC）和大细胞性（LC）淋巴瘤。从1992年1月至1998年6月，TPOG的13家成员医院招募了200例新诊断的NHL患儿。其中有140名男孩和60名女孩。他们确诊时的年龄为2.4个月至18.3岁，中位数为8.2岁。有54例（27.3%）LB患者，94例（47.5%）SNC患者（包括B细胞急性淋巴细胞白血病（B-ALL）），50例（25.2%）LC患者。疾病的I、II、III和IV期（包括B-ALL）分别占病例的5%、10%、43%和42%。有176例患者符合治疗结果评估条件。诱导缓解率为82.4%，22例（12.5%）患者诱导失败，9例患者在诱导期死亡。截至1999年8月31日，26例患者复发，6例在缓解期死亡，1例患者发生继发性急性粒单核细胞白血病，105例患者持续缓解，缓解期中位数为49个月。LB、SNC和LC组7年无事件生存率（EFS）分别为63.5%、61.5%和65%（P = 0.8298）。疾病I/II期、III期和IV期的7年EFS分别为73%、68.9%和50.3%（P = 0.0212）。我们得出结论，遵循分层治疗策略，在本研究中只有疾病分期具有预后意义。需要做出更多努力来改善我们的治疗结果。
