Department of Haematology, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK.
Am J Hematol. 2010 Apr;85(4):261-3. doi: 10.1002/ajh.21648.
The chemotherapy dose-intensity in two adapted German BFM paediatric protocols (BFM 90 and NHL 86) was compared in contemporaneously treated adults <50 years with Burkitt lymphoma and B-cell lymphoma unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (collectively referred to as BL). In BFM 90, primary prophylaxis with Granulocyte-colony-stimulating factor was used, postinduction treatment was started at granulocytes > or =0.5 x 10(9)/L (> or =1.0 x 10(9)/L in NHL 86) with a higher mean methotrexate dose (2.9 g/m(2)/cycle, n = 23; 1.6 g/m(2)/cycle in NHL 86, n = 22, P < 0.001). Intervals between consecutive treatment-cycles were shorter in BFM 90 (P < 0.001) with no additional toxicity. However, the two-year failure-free survival with BFM 90 (82%) was similar to that achieved with NHL 86 (72%, P = 0.33). We conclude that BFM 90 enables safe intensification of therapy in young adults with BL compared to NHL 86, but registry-based studies are required to further evaluate the antineoplastic effects and cost-effectiveness of the two therapeutic approaches.
在同时治疗的 50 岁以下伯基特淋巴瘤和 B 细胞淋巴瘤不能分类，具有弥漫性大 B 细胞淋巴瘤和伯基特淋巴瘤之间特征的成年患者中，比较了两个适应德国 BFM 儿科方案（BFM 90 和 NHL 86）的化疗剂量强度。在 BFM 90 中，使用粒细胞集落刺激因子进行原发性预防，在诱导后治疗在粒细胞 >或=0.5 x 10(9)/L（在 NHL 86 中>或=1.0 x 10(9)/L）时开始，使用更高的平均甲氨蝶呤剂量（2.9 g/m(2)/周期，n = 23；在 NHL 86 中为 1.6 g/m(2)/周期，n = 22，P <0.001）。BFM 90 中连续治疗周期之间的间隔更短（P <0.001），但没有额外的毒性。然而，BFM 90 的两年无失败存活率（82%）与 NHL 86 相似（72%，P = 0.33）。我们的结论是，与 NHL 86 相比，BFM 90 可使 BL 年轻成年人的治疗安全强化，但需要基于注册的研究来进一步评估两种治疗方法的抗肿瘤效果和成本效益。
