非洲采用改良LMB方案治疗B细胞淋巴瘤——法非儿科肿瘤协作组（GFAOP）报告

Treatment of B-cell lymphoma with LMB modified protocols in Africa--report of the French-African Pediatric Oncology Group (GFAOP).

作者信息

Harif Mhamed, Barsaoui Sihem, Benchekroun Said, Bouhas Rachid, Doumbé Pierre, Khattab Mohammed, Ladjaj Yasmina, Moreira Claude, Msefer-Alaoui Fouzia, Patte Catherine, Rakotonirina Gervais, Raphael Martine, Raquin Marie-Anne, Lemerle Jean

机构信息

Service d'Hématologie et Oncologie Pédiatrique, Hôpital 20 Août 1953, Casablanca, Morocco.

出版信息

Pediatr Blood Cancer. 2008 Jun;50(6):1138-42. doi: 10.1002/pbc.21452.

DOI:10.1002/pbc.21452

PMID:18213709

Abstract

BACKGROUND

The French African Paediatric Oncology Group (GFAOP) was set up in October 2000 to improve the quality of care of children with cancer in Africa. Eight pediatric oncology units from Algeria, Cameroon, Madagascar, Morocco, Tunisia, and Senegal have been involved.

METHODS

Patients less than 18 years with cytology or histology proven B-cell non-Hodgkin lymphoma were included. Two LMB89 modified regimens were proposed (MAT and GFA).

RESULTS

From April 2001 to April 2004, 343 cases were registered. Thirty seven patients were excluded. Thirteen patients were stage I, 26 stage II, 209 stage III and 50 stage IV including 8 L3 acute lymphoblastic leukemia (ALL3) cases. Three year OS of the whole population of patients is 61%. In GFA group 36 months OS is 63.6% in stages I/II, 51.6% in stage III and 35.8% in stage IV. In MAT group, the OS is 84.4% in stages I/II, 76.2% in stage III and 55.6% in stage IV. Seventy one patients died during treatment, 32 at pre-induction phase, 27 at induction and 12 at consolidation. Treatment related mortality decreased during the 3-year inclusion period (first year: 25.7%, second year: 19.1%, third year: 11.6%). The improvement of supportive care translated into an increase of the overall survival rates from 54% in the first year to 73% in the third year.

CONCLUSION

These data demonstrate the feasibility of prospective multicentric studies in Africa. An improvement of quality of care has been noticed during the 3 first years.

摘要

背景

法国非洲儿科肿瘤学组（GFAOP）于2000年10月成立，旨在提高非洲癌症儿童的护理质量。来自阿尔及利亚、喀麦隆、马达加斯加、摩洛哥、突尼斯和塞内加尔的8个儿科肿瘤学单位参与其中。

方法

纳入年龄小于18岁、细胞学或组织学确诊为B细胞非霍奇金淋巴瘤的患者。提出了两种改良的LMB89方案（MAT和GFA）。

结果

2001年4月至2004年4月，共登记343例病例。37例患者被排除。13例为I期，26例为II期，209例为III期，50例为IV期，其中包括8例L3急性淋巴细胞白血病（ALL3）病例。所有患者的三年总生存率为61%。在GFA组中，I/II期36个月总生存率为63.6%，III期为51.6%，IV期为35.8%。在MAT组中，I/II期总生存率为84.4%，III期为76.2%，IV期为55.6%。71例患者在治疗期间死亡，32例在诱导前期死亡，27例在诱导期死亡，12例在巩固期死亡。在3年的纳入期内，治疗相关死亡率有所下降（第一年：25.7%，第二年：19.1%，第三年：11.6%）。支持性护理的改善使总生存率从第一年的54%提高到第三年的73%。