Karadeniz Ceyda, Oguz Aynur, Citak Elvan Caglar, Uluoglu Omer, Okur Visal, Demirci Selda, Okur Arzu, Aksakal Nur
Gazi University Faculty of Medicine, Department of Pediatric Oncology, Ankara, Turkey.
Pediatr Hematol Oncol. 2007 Sep;24(6):417-30. doi: 10.1080/08880010701450972.
The aim of this study was to evaluate and compare the clinical characteristics of the B-cell non-Hodgkin lymphoma (NHL) patients and therapeutic efficacy of modified NHL BFM-90 and NHL BFM-95 protocols in the authors' center. From January 1993 to December 2003, 61 newly diagnosed children with B-NHL were enrolled to the study. The patients were stratified by risk factors and treated either with a modified B-NHL BFM-90 or BFM-95 protocols. The use of 1 or 3 g/m2 of methotrexate instead of 5 g/m2/24 h was the only important modification in BFM-90 protocol. Sixty-one children (12 girls, 49 boys) with a median age of 6.5 years (range: 2.5-16) were treated in the center. There were 14 patients in stage II, 28 in stage III, and 19 in stage IV. The most common initial primary tumor sites were abdomen, head, and neck. Forty-five patients were treated with modified B-cell BFM-90 and 16 patients were treated with B-cell BFM-95 regimens. The 5-year overall survival (OS) for all patients was 85.8%, and event-free survival (EFS) was 82.8%. The 5-year OS rates in modified BFM-90 and in BFM-95 protocols were 85.2 and 87.5%; the 5-year EFS rates in these 2 protocols were 84.6 and 70%, respectively (p >.05). Factors associated with lower EFS by univariate analysis were bulky disease, risk groups, and LDH level > or = 500 IU/L. By multivariate analysis only LDH level was significant. In conclusion, the treatment results in this study were similar to those of BFM group.
本研究旨在评估和比较作者所在中心B细胞非霍奇金淋巴瘤(NHL)患者的临床特征以及改良的NHL BFM-90和NHL BFM-95方案的治疗效果。1993年1月至2003年12月,61例新诊断的儿童B-NHL患者纳入本研究。患者根据危险因素分层,接受改良的B-NHL BFM-90或BFM-95方案治疗。BFM-90方案唯一重要的改变是使用1或3 g/m²的甲氨蝶呤替代5 g/m²/24 h。该中心共治疗了61例儿童(12例女孩,49例男孩),中位年龄6.5岁(范围:2.5 - 16岁)。II期患者14例,III期28例,IV期19例。最常见的初始原发肿瘤部位是腹部、头颈部。45例患者接受改良的B细胞BFM-90方案治疗,16例患者接受B细胞BFM-95方案治疗。所有患者的5年总生存率(OS)为85.8%,无事件生存率(EFS)为82.8%。改良BFM-90和BFM-95方案的5年OS率分别为85.2%和87.5%;这两个方案的5年EFS率分别为84.6%和70%(p>.05)。单因素分析显示,与较低EFS相关的因素有大包块病变、风险组以及乳酸脱氢酶(LDH)水平≥500 IU/L。多因素分析显示只有LDH水平具有显著性。总之,本研究的治疗结果与BFM组相似。