Rivera-Luna R, Cárdenas-Cardós R, Martínez-Avalos A, Leal-Leal C, Ruano-Aguilar J, Meza-Coria C, Lanche-Guevara T, de León-Bojorge B
Departamento de Oncología, Instituto Nacional de Pediatría, México, D.F.
Rev Invest Clin. 1994 Sep-Oct;46(5):369-75.
Fifty three pediatric patients with the histopathological diagnosis of lymphoblastic lymphoma (LL) were studied in a retrospective analysis during a 14 year period. Their age ranged from 1 to 16 years with a median of 7 years. Clinical staging was performed according to Murphy's system. There was one child in stage I (2%), 11 in stage II (21%), 14 stage III (26%) and 27 stage IV (51%). Patients in stage IV, 21 (78%) had initial bone marrow involvement, 4 (15%) central nervous system (CNS) infiltration and 2 (7%) simultaneous infiltration to the bone marrow and the CNS. The chemotherapy program consisted of induction, consolidation and maintenance with CNS prophylaxis. The whole program lasted 36 months. Out of 53 patients there were only 45 evaluable for treatment analysis response. A total of 14 (31%) are alive and in a continuous complete remission, with a median duration of remission of 66 months, 8 (18%) children abandoned treatment with a median duration of remission of 10 months. Twenty three patients (51%) are dead. The actuarial survival at 11 year is of 39% +/- 11% with a median remission rate for the whole group of 11.8 months. No patient in complete remission for more than 24 months has relapsed. We conclude that our chemotherapy program is more than adequate for early stages, but for advanced disease it has been a failure. There is a need to modify the chemotherapy program using a very similar protocol as the one used in high risk childhood acute lymphoblastic leukemia.
在一项为期14年的回顾性分析中，对53例经组织病理学诊断为淋巴细胞性淋巴瘤（LL）的儿科患者进行了研究。他们的年龄在1至16岁之间，中位数为7岁。根据墨菲系统进行临床分期。I期有1名儿童（2%），II期有11名（21%），III期有14名（26%），IV期有27名（51%）。IV期患者中，21名（78%）最初有骨髓受累，4名（15%）有中枢神经系统（CNS）浸润，2名（7%）同时有骨髓和CNS浸润。化疗方案包括诱导、巩固和维持治疗并进行CNS预防。整个方案持续36个月。53例患者中只有45例可评估治疗反应。共有14例（31%）存活且持续完全缓解，缓解期中位数为66个月，8例（18%）儿童放弃治疗，缓解期中位数为10个月。23例患者（51%）死亡。11年的精算生存率为39%±11%，全组缓解率中位数为11.8个月。完全缓解超过24个月的患者均未复发。我们得出结论，我们的化疗方案对早期疾病足够有效，但对晚期疾病则是失败的。需要使用与高危儿童急性淋巴细胞白血病所用方案非常相似的方案来修改化疗方案。
