Sun Xiao-Fei, Liu Dong-Geng, Zhen Zi-Jun, Chen Xizo-Qing, Xia Yi, Wang Zhi-Hui, He You-Jian, Guan Zhong-Geng
Department of Medical Oncology, Cancer Center, Sun Yat-Sen University, Guangzhou 510060, China.
Zhonghua Xue Ye Xue Za Zhi. 2005 Oct;26(10):581-4.
To evaluate the efficacy and toxicity of the B-NHL-BFM-90 protocol in the treatment of Chinese childhood and adolescent B-cell non-Hodgkin's lymphomas (B-NHL).
Forty-two untreated childhood and adolescent B-NHL were enrolled in the present study. Of them 18 cases were Burkitt's lymphoma, 16 diffuse large B cell lymphoma and 8 anaplastic lymphoma. There were 10 cases in stage II and 32 in stage III/IV. The patients were grouped by risk factors into low, medium and high risk groups. All patients were treated with the B-NHL-BFM 90 (Berlin-Frankfurt- Münster) protocol. The low risk group received A, B courses for 4 cycles, the medium risk group AA, BB courses for 6 cycles, and the high risk group AA, BB, CC courses for 6 cycles.
Complete remission (CR) was obtained in 37 patients (88%), and partial remission (PR) in 5 (12%). Of the 5 PR patients, I received autologous hematopoietic stem cell transplantation, 3 received radiotherapy for residual disease and 1 just under watching. Major toxicity was myelosuppression and mucositis, especially in AA, BB and CC cycles, but was tolerant and manageable. Median follow-up was 20 (4 - 89) months. Kaplan-Meier method was used to analyse survival data. Two year event free survival (EFS) for all patients was 86. 24%, being 100% for stage II and 80.95% for stage III/IV.
Short term and intensive chemotherapy can improves the efficacy and survival rate of childhood and adolescent B-NHL, especially for advanced stage patients.
评估B-NHL-BFM-90方案治疗中国儿童及青少年B细胞非霍奇金淋巴瘤（B-NHL）的疗效及毒性。
本研究纳入42例未经治疗的儿童及青少年B-NHL患者。其中18例为伯基特淋巴瘤，16例为弥漫性大B细胞淋巴瘤，8例为间变性淋巴瘤。Ⅱ期患者10例，Ⅲ/Ⅳ期患者32例。根据危险因素将患者分为低、中、高风险组。所有患者均采用B-NHL-BFM 90（柏林-法兰克福-明斯特）方案治疗。低风险组接受A、B疗程共4个周期，中风险组接受AA、BB疗程共6个周期，高风险组接受AA、BB、CC疗程共6个周期。
37例患者（88%）获得完全缓解（CR），5例（12%）获得部分缓解（PR）。在5例PR患者中，1例接受了自体造血干细胞移植，3例对残留病灶进行了放疗，1例仅进行观察。主要毒性为骨髓抑制和黏膜炎，尤其是在AA、BB和CC周期，但可耐受且可控制。中位随访时间为20（4 - 89）个月。采用Kaplan-Meier法分析生存数据。所有患者的两年无事件生存率（EFS）为86.24%，Ⅱ期患者为100%，Ⅲ/Ⅳ期患者为80.95%。
短期强化化疗可提高儿童及青少年B-NHL的疗效及生存率，尤其是对于晚期患者。
