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[NHL-BFM 90治疗儿童和青少年恶性非霍奇金淋巴瘤的研究。第2部分:非B细胞非霍奇金淋巴瘤治疗组的中期分析。BFM研究组]

[NHL-BFM 90 therapy study in treatment of malignant non-Hodgkin's lymphomas in children and adolescents. Part 2: An intermediate term analysis of the non-B-NHL therapy group. BFM Study group].

作者信息

Reiter A, Schrappe M, Yakisan E, Sauter S, Henzler D, Zimmermann M, Graf N, Fengler R, Kühl J, Fleischhack G

机构信息

Abt. Päd. Hämatologie/Onkologie, Med. Hochschule Hannover.

出版信息

Klin Padiatr. 1994 Jul-Aug;206(4):234-41. doi: 10.1055/s-2008-1046609.

Abstract

The goals of study NHL-BFM 90 for the therapy group Non-B NHL are to prospectively evaluate the dynamic of tumor regression and the persistence of a residual mass after induction therapy for its prognostic impact. Patients (pts) of stages I and II receive induction composed of prednisone, vincristine (VCR), daunorubicin, L-asparaginase (L-ASP), cyclophosphamide (CP), cytarabine (ARA-C), 6-mercaptopurine (6-MP) and intrathecally (i.th.) methotrexate (MTX), followed by consolidation (6-MP,MTX 5 g/m2 x 4, MTX i.th.), and maintenance up to 24 months. Pts of stages III and IV receive additionally reinduction (Dexamethasone, VCR, doxorubicin, L-ASP, CP, ARA-C, 6-thioguanine, MTX i.th.) and cranial irradiation. Pts with < 70% tumor regression at day 33 of induction receive an intensified chemotherapy. Pts with > 70% tumor regression at day 33 but a persistent mass at the end of induction have a surgical resection. Pts with a completely necrotic residual mass continue with consolidation therapy. Pts with active residual lymphoma receive an intensified chemotherapy. No local radiotherapy is given. From 4/1990 to 12/1992, 80 pts were registered; 71 pts are evaluable for response. The distribution of stages is as follows: 6, 1, 47, 17 pts of stage I, II, III, IV, respectively. The probability of event free survival at 3 years is 87 +/- 4% for the whole group (median observation time 21 months). 66 pts are evaluable for the dynamic of response.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

针对非B型非霍奇金淋巴瘤(NHL)治疗组的NHL - BFM 90研究目标是前瞻性评估诱导治疗后肿瘤消退的动态变化以及残留肿块的持续存在情况及其预后影响。Ⅰ期和Ⅱ期患者接受的诱导治疗包括泼尼松、长春新碱(VCR)、柔红霉素、L - 天冬酰胺酶(L - ASP)、环磷酰胺(CP)、阿糖胞苷(ARA - C)、6 - 巯基嘌呤(6 - MP)及鞘内注射甲氨蝶呤(MTX),随后进行巩固治疗(6 - MP、5g/m²×4的MTX、鞘内注射MTX),并维持治疗长达24个月。Ⅲ期和Ⅳ期患者还需接受再诱导治疗(地塞米松、VCR、阿霉素、L - ASP、CP、ARA - C、6 - 硫鸟嘌呤、鞘内注射MTX)及颅脑照射。诱导治疗第33天时肿瘤消退<70%的患者接受强化化疗。诱导治疗第33天时肿瘤消退>70%但诱导结束时仍有残留肿块的患者进行手术切除。残留肿块完全坏死的患者继续进行巩固治疗。残留淋巴瘤仍有活性的患者接受强化化疗。不进行局部放疗。从1990年4月至1992年12月,登记了80例患者;71例患者可评估疗效。分期分布如下:Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期分别有6例、1例、47例、17例患者。全组3年无事件生存率为87±4%(中位观察时间21个月)。66例患者可评估反应动态。(摘要截选至250字)

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