Forns Marga, Javier Germán, Estella Jesús, Fernández-Delgado Rafael, Gallego Soledad, García-Miguel Purificación, Indiano José M, Navajas Aurora, Pardo Nuria
Servicio de Cirugía General, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
Med Clin (Barc). 2007 May 5;128(17):641-6. doi: 10.1157/13102049.
After the good results obtained by the Société Française d'Oncologie Pédiatrique (SFOP) regarding the pediatric B-type non-Hodgkin's (Burkitt and large B-cell) lymphoma and L3 leukemia, the Sociedad Española de Hematología y Oncología Pediátricas (SHOP) decided to use the same treatment protocol.
Pediatric patients diagnosed with B-type non-Hodgkin's lymphoma without a previous history of malignant diseases were eligible for this study. They were classified in 3 groups of risk: group A (resected stage I and abdominal stage II), group B (not eligible for groups A or C), and group C (with central nervous system involvement and L3 leukemia). All received treatment according to the SFOP's LMB89 protocol.
A total of 153 patients were considered in this multicenter, prospective and non-randomized trial (1997-2005). The global and event-free survival (EFS) were found to be of 88% (0.88; 95% confidence interval [CI], 0.83-0.93) and 85% (0.85; 95% CI, 0.79-0.90), respectively. The EFS was 100% for the group A (n = 16), 86% (0.86; 95% CI, 0.79-0.92) for the group B (n = 113), and 68% (0.68; 95% CI, 0.49-0.86) for the group C (n = 24).
The results confirm the good efficiency of the LMB89 protocol for treating B-cell lymphoma and L3 leukemia, despite having diminished the treatment intensity in the less risk groups. The worst prognostic factor was found to be a central nervous system involvement, whereas being younger than 10 years was confirmed to be a favorable prognostic factor. In addition, no differences were evidenced between Burkitt and large B-cell lymphoma.
法国儿科肿瘤学会(SFOP)在小儿B型非霍奇金淋巴瘤(伯基特淋巴瘤和大B细胞淋巴瘤)及L3白血病治疗方面取得良好效果后,西班牙儿科血液学与肿瘤学会(SHOP)决定采用相同的治疗方案。
诊断为B型非霍奇金淋巴瘤且无既往恶性疾病史的小儿患者符合本研究条件。他们被分为3个风险组:A组(I期切除及腹部II期)、B组(不符合A组或C组条件)和C组(有中枢神经系统受累及L3白血病)。所有患者均按照SFOP的LMB89方案接受治疗。
在这项多中心、前瞻性且非随机的试验(1997 - 2005年)中,共纳入153例患者。总体生存率和无事件生存率(EFS)分别为88%(0.88;95%置信区间[CI],0.83 - 0.93)和85%(0.85;95% CI,0.79 - 0.90)。A组(n = 16)的EFS为100%,B组(n = 113)为86%(0.86;95% CI,0.79 - 0.92),C组(n = 24)为68%(0.68;95% CI,0.49 - 0.86)。
结果证实LMB89方案治疗B细胞淋巴瘤和L3白血病效果良好,尽管在低风险组降低了治疗强度。发现最差的预后因素是中枢神经系统受累,而年龄小于10岁被确认为有利的预后因素。此外,伯基特淋巴瘤和大B细胞淋巴瘤之间未发现差异。