Prerequisites to improvement of predictive model of childhood Hodgkin’s lymphoma

2015 ◽  
Vol 6 (4) ◽  
pp. 13-18
Author(s):  
Svetlana Aleksandrovna Kulyova ◽  
Andrei Petrovich Karitsky ◽  
Svetlana Viacheslavovna Ivanova
Keyword(s):  
Overall Survival ◽  
Hodgkin’S Lymphoma ◽  
Roc Analysis ◽  
Risk Group ◽  
Survival Rates ◽  
Late Results ◽  
Tumor Burden ◽  
Hodgkin's Lymphoma ◽  
Event Free Survival ◽  
Free Survival

Background. Calculation of relative tumor burden in Hodgkin’s lymphoma patients is the simplest and significant parameter which can be used in daily clinical practice as a risk factor. The aim of study was the assessment of influence of relative tumor burden on the late results of a disease. Material and methods. This research included data on 126 patients with Hodgkin’s lymphoma aged from 0 till 18 years (middle age of 11 years), treated risk-adapted treatment according to the DAL-HD and SPBLH-05. Boys was 70, girls - 56 (a ratio 1,25 : 1). Fifty-eight patients (46 %) are stratified in favorable risk group, 50 (39,7 %) - in intermediate risk group, and 50 (39,7 %) are included in unfavorable risk group. Results. Overall survival at 5 years was 93 % (range 91-95 %), event-free survival - 88 % (85-91 %). The average relative tumor burden was 129,4 cm3/m2 (7-609,7 cm3/m2). When carrying out ROC-analysis value of 122,7 cm3/m2 (р ˂ 0,0001) appeared the critical parameter, which worsen the prognosis of a disease. Overall survival in a patients cohort with this volume was 69,6 %, with the volume less than 122,7 cm3/m2 overall survival was 97,2 % (р = 0,00002). Conclusions. The relative tumor burden is the parameter which is significantly reducing survival rates in children with Hodgkin’s lymphoma. Opinion on interrelation of clinical and laboratory parameters with “sarkoma’s saturation” or tumor volume as end result of immunological frustration, it is represented the most perspective direction of studying of Hodgkin’s lymphoma.

An Improved Prognostic Parameter for Non-Hodgkin's Lymphoma Based on the Combination of Three Serum Tumor Markers

2008 ◽  
Vol 23 (4) ◽  
pp. 207-213
Author(s):  
W. Gui ◽  
T. Wang ◽  
J. Wang ◽  
L. Wang ◽  
J. He ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Markers ◽  
Prognostic Value ◽  
Hodgkin’S Lymphoma ◽  
Survival Rates ◽  
Hodgkin's Lymphoma ◽  
Event Free Survival ◽  
Free Survival ◽  
Serum Tumor Markers ◽  
Non Hodgkin's Lymphoma

We aimed to evaluate the prognostic value of the combination of three serum tumor markers (LDH, β2-M and CA 125) in patients with non-Hodgkin's lymphoma (NHL). Clinical and pathological variables including the levels of these markers were measured in 415 NHL patients. Statistical analysis showed that increased levels of all three markers were associated with stage, B symptoms, effusions, bone marrow involvement, and International Prognostic Index (IPI) in NHL patients (p<0.05). Overall survival and event-free survival rates were associated not only with LDH but also with β2-M and CA125 (p<0.001). Response to treatment and overall survival rates were different in three groups with elevated LDH; in particular, the combination of three or two elevated markers seemed to identify a group of patients at higher risk of treatment failure and/or relapse than the group with a high LDH level only. Furthermore, multiple Cox regression analysis showed that IPI score complemented by the additional serum markers β2-M and CA125 was a better prognosticator of overall and event-free survival than LDH alone. This result suggests that if the combination of three elevated serum tumor markers is included as a parameter in the IPI instead of LDH alone, the prognostic value of IPI can be improved.

Children's oncology in St. Petersburg: achievements and prospects of development

2015 ◽  
Vol 6 (4) ◽  
pp. 5-12
Author(s):  
Margarita Borisovna Belogurova ◽  
Elmira Gosmanovna Boichenko ◽  
Svetlana Aleksandrovna Kulyova
Keyword(s):  
Overall Survival ◽  
Hodgkin’S Lymphoma ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Hodgkin's Lymphoma ◽  
Genetic Diagnostics ◽  
Hereditary Cancer Syndrome ◽  
Event Free Survival ◽  
Cancer Syndrome ◽  
Free Survival

The statistics (incidence, mortality, survival) characterizing a problem and the oncological care to children with malignant tumors in St. Petersburg are presented in the article. It is proved that intensification in the therapeutic regimens according to immunohistochemical features, age, extending of tumor significantly raised survival rates, having approached them to the world. The five-year survival of children treated in the 90th of the last century in St. Petersburg, was 60,9 %, at the beginning of the 2000th increase of survival to 69,3 % with approach to European survival (71,8 %) is noted. Improvement of indicators of survival, first of all, should be explained with progress in therapy of the most widespread localizations - leukemias and central nervous system tumors. Thanks to an intensification of treatment it was succeeded to improve considerably results of treatment of children with acute leukemia: the survival from 10-15 % in the 70-80th reached 80 %. Traditionally good results were observed at Hodgkin’s lymphoma: the 5-year overall survival was 94% with event-free survival of 87 %. Using of the European protocol for treatment of Wilm’s tumor (SIOP 93-01) increased survival of children with a unilateral tumor to 94,4 % at the overall survival more than 80 %. Improvement of overall survival in children was influenced also by introduction in practice protocols of BFM (Berlin-Frankfurt-Münster) for treatment non-Hodgkin’s lymphoma thanks to what 5-year event-free survival increased from 30 to 81 %. Now the perspective in children’s oncology are development of molecular and genetic diagnostics with search the germ mutations at a hereditary cancer syndrome, definition of a range of somatic mutations in genes at sporadic malignant tumors at children.

Outcomes of Eam Conditioned Autologous Haematopoietic Stem Cell Transplantation for Lymphoma. A Matched Pairs Retrospective Single Centre Study Analysis.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3088-3088
Author(s):  
Justin Ching Ting Loke ◽  
Janice Ward ◽  
Prem Mahendra ◽  
Sridhar Chaganti ◽  
Ram Malladi
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
Lung Function ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Haematopoietic Stem Cell ◽  
Event Free Survival ◽  
Free Survival ◽  
Related Mortality

Abstract Abstract 3088 Background: High dose chemotherapy followed by autologous stem cell rescue is superior to salvage chemotherapy alone in relapsed Hodgkin's Lymphoma (HL) and Non-Hodgkin's lymphoma (NHL). A commonly used regimen is BEAM (BCNU, Etoposide, Cytarabine and Melphalan). Unfortunately, BCNU is associated with potentially lethal pulmonary interstitial toxicity, in a dose dependent manner. Therefore, it is often omitted in conditioning regimens for patients who have pre-existing impaired lung function. We aimed to determine the outcomes of patients given this EAM (Etoposide, Cytarabine, Melphalan) schedule in our centre. Method: At our unit, from 2000–2010, 338 patients had been transplanted with BEAM conditioning and 23 patients with an EAM regimen. BEAM chemotherapy involved cumulative doses of BCNU at 300 mg/m2, etoposide at 800 mg/m2, cytarabine at 1600 mg/m2 and melphalan at 140 mg/m2. The EAM regimen was the same, except for the omission of BCNU. We wanted to compare overall survival, event free survival and transplant related mortality between the two groups of patients. A matched-pair analysis based on age and sex on a 1:1 basis was conducted. Survival rates were estimated by the Kaplan-Meier method. Differences between the survival distributions were compared with the log-rank test. Results: 23 patients transplanted with an EAM regimen was matched with an equal number transplanted with a BEAM conditioning regimen. The median age was 53 in both groups. The median follow-up for patients alive was 3.2 years. Further baseline characteristics of the two groups are described in table 1. Other than a slight predominance of more advanced disease in the BEAM cohort, the two groups were evenly matched. Survival estimates were statistically significantly poorer for the EAM group compared to the BEAM group. The median overall survival for the EAM cohort was 29 months compared to 77 months (p=0.03) for the matched BEAM cohort. The median event free survival for the EAM cohort was 11 months compared to 63 months (p=0.02) for the BEAM cohort. The 100 day transplant related mortality was 8.7% for both cohorts. During the follow-up period 11 patients died of disease related causes in the EAM group compared to 6 in the BEAM group. Conclusion: Despite the prevalence of pre-existing lung disease in the EAM group of patients, the conditioning was reasonably well tolerated. Our analysis suggests that patient transplanted with an EAM regimen had an inferior survival outcome to patients treated with the standard BEAM regimen. This data provides evidence for the importance of BCNU in lymphoma control; consideration should be given to a reduction in BCNU dosage, rather than simple omission, for patients with borderline lung function results. Collaboration with other centres is warranted to determine if this experience with EAM is replicated elsewhere. Disclosures: No relevant conflicts of interest to declare.

Survival and prognostic factors in a series of adults with medulloblastomas

2009 ◽  
Vol 111 (3) ◽  
pp. 478-487 ◽  
Author(s):  
Laurent Riffaud ◽  
Stephan Saikali ◽  
Emmanuelle Leray ◽  
Abderrahmane Hamlat ◽  
Claire Haegelen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
High Risk ◽  
Survival Time ◽  
Risk Group ◽  
Survival Rates ◽  
Event Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Standard Risk

Object In this article, the authors report their experience in the management of adult patients with medulloblastoma at their institution to identify prognostic factors important for survival and disease control. Methods Between 1977 and 2005, 27 patients who were ≥ 16 years old and had medulloblastoma were treated consecutively. There were 16 women and 11 men with a median age of 21 years (range 16–54 years). Gross-total resection was performed in 21 patients, subtotal (≥ 90%) in 2, incomplete in 1, and biopsy in 3 patients. Six patients had the desmoplastic variant, and 21 patients presented with classic medulloblastoma. Staging according to the Chang classification showed 4 patients with tumors invading the brainstem (2 with Stage T3b and 2 with Stage T4), 3 patients with metastases (2 with Stage M2 and 1 with Stage M3), and 1 patient in whom the stage was unknown (Stage MX) who died 10 days postoperatively. Twenty patients were assigned to the standard-risk group and 7 to the high-risk group. All patients except the one whose status was classified as Stage MX underwent craniospinal radiotherapy at our institution. Seven patients received chemotherapy before radiotherapy. Results The 5- and 10-year overall survival rates for the present study were 81 and 62%, respectively. The median overall survival time was 17.7 years. The 5- and 10-year event-free survival rates were 72 and 57%, respectively. The median event-free survival time was 17.9 years. Univariate analysis showed that survival was significantly correlated with sex (women had a better prognosis than men) and M stage (patients without metastases had a better outcome). Patient age, duration of symptoms, Karnofsky Performance Scale score at presentation, hydrocephalus, tumor location, brainstem invasion, extent of resection, histological subtype, preradiotherapy chemotherapy, risk group, and period of presentation were not significant variables. Multivariate analysis identified sex and M stage as well as the period of presentation as independent prognostic factors for overall and event-free survival times. Eleven patients suffered tumor recurrence within a median time of 4.2 years. The posterior fossa was not the most common site of recurrence, and delayed recurrence was not rare. All patients in whom the tumor recurred have died despite aggressive treatments. The median survival time after diagnosis of recurrence was 2.5 years. Questionnaires on quality of life and cognition showed high scores in favor of limited negative effects in the perception of mental and physical health after treatment. The authors observed 1 supposed second malignancy (thyroid carcinoma) and no evidence of pituitary dysfunction. Conclusions Long-term survival is possible in adults treated for medulloblastoma. Although rare, metastasis seeding at presentation is a poor prognostic factor. The possibility of delayed recurrence necessitates close follow-up of all patients. Tumor recurrences should be treated with aggressive therapies as some patients may have sustained response. Adjuvant chemotherapy should be given to high-risk patients, but its role in reducing recurrences, particularly distant ones, remains unclear in the standard-risk group.

scholarly journals Treatment results of Hodgkin’s lymphoma

Medicina ◽  
2009 ◽  
Vol 45 (8) ◽  
pp. 615 ◽  
Author(s):  
Eduardas Aleknavičius ◽  
Konstantinas Valuckas ◽  
Birutė Aleknavičienė ◽  
Laura Norkienė ◽  
Giedrė Smailytė
Keyword(s):  
Overall Survival ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Intermediate Stage ◽  
Hodgkin's Lymphoma ◽  
Advanced Stage ◽  
Event Free Survival ◽  
Early Stage Disease ◽  
Free Survival ◽  
Stage Disease

During last decades, there are strengthening attitudes to optimize the treatment of Hodgkin’s lymphoma considering prognostic groups and risk factors. Based on the data of Vilnius University Clinics, a retrospective study was carried out, and treatment methods and outcomes of the patients treated during 1999– 2004 were analyzed. Medical histories of 114 patients younger than 60 years were reviewed. Median age was 28 years. In 83% of cases, classic nodular sclerotic Hodgkin’s lymphoma was diagnosed. Advanced-, intermediate-, and early-stage disease was diagnosed in 55%, 38%, and 7% of cases, respectively. The patients with early-stage disease underwent four ABVD chemotherapy courses; 88% of them underwent radiotherapy afterwards. The patients with intermediate-stage disease underwent 4–6 courses of ABVD or in minor cases (12% of patients with intermediate-stage disease) – 4 standard BEACOPP chemotherapy courses. After this treatment, 88% of patients with intermediate-stage disease underwent radiotherapy. Patients with advanced-stage disease underwent 8 escalate (44%) or standard BEACOPP (29%) chemotherapy courses. More than half of these patients (71%) underwent radiotherapy after chemotherapy. Patient follow-up median was 65 months. One hundred seven patients (94%) after primary treatment achieved complete remission, in 7 patients (6%) primary progression was observed, 12 patients (11%) relapsed, and 8 patients died. Overall survival and event-free survival in patients with early-stage disease was 100%. Overall survival in patients with early/intermediate- and advanced-stage disease was 95.1% and 84.0%, respectively. Event-free survival in patients with early/intermediate- and advanced-stage disease was 91.7% and 76.2%, respectively. In the groups of intermediate- and advanced-stage disease, the results of treatment were worse in the subgroup, which underwent extended-field radiotherapy (P<0.05). Overall survival in the group of patients with advanced-stage disease was the best who underwent ABVD scheme, but the event-free survival (70.6%) and disease-free survival (81.3%) in ABVD subgroup were worse compared to BEACOPP subgroup. According to our results, there was no statistically significant difference in survival of patients with advanced-stage disease who underwent or did not radiotherapy (P>0.05).

Effect of Race on the Outcome of Pediatric Patients With Hodgkin's Lymphoma

2008 ◽  
Vol 26 (8) ◽  
pp. 1282-1288 ◽  
Author(s):  
Monika L. Metzger ◽  
Sharon M. Castellino ◽  
Melissa M. Hudson ◽  
Shesh N. Rai ◽  
Sue C. Kaste ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Clinical Characteristics ◽  
Hemoglobin Concentration ◽  
Black Children ◽  
Hodgkin's Lymphoma ◽  
Event Free Survival ◽  
White Children ◽  
Free Survival ◽  
Black And White ◽  
Black Patients

Purpose Some cooperative groups have found a survival disadvantage in black children with various childhood cancers. We examine the effects of race on clinical outcomes among children with Hodgkin's lymphoma (HL) treated with contemporary therapy at a tertiary care children's hospital. Patients and Methods Retrospective analysis of 327 children and adolescents diagnosed with HL between 1990 and 2005. Patients were treated with risk-directed multimodal therapy regardless of race, ethnicity, or ability to pay. Event-free and overall survival rates were compared for black and white children. Clinical characteristics, socioeconomic factors, and biologic features were analyzed for prognosis of treatment failure. Results The 262 white and 65 black patients did not differ significantly in presenting features, clinical characteristics, or enrollment in a clinical trial. More black patients (71% v 45%) resided in poor counties (P < .001). While black and white children were equally likely to have progressive disease or early relapse, black children were 3.7 times (95% CI, 1.7 to 8.0) more likely to relapse 12 months or more after diagnosis. The 5-year event-free survival was 71% ± 6.1% (SE) for black and 84% ± 2.4% for white children (P = .01). However, the 5-year survival rate did not differ between white and black children (94.4% v 94.7%). While black race and low hemoglobin concentration were independent predictors of treatment failure, only low hemoglobin concentration independently predicted poor survival. Conclusion Black children with Hodgkin's lymphoma have lower event-free survival than white children, but both populations have the same 5-year overall survival.

ABVD Versus Modified Stanford V Versus MOPPEBVCAD With Optional and Limited Radiotherapy in Intermediate- and Advanced-Stage Hodgkin's Lymphoma: Final Results of a Multicenter Randomized Trial by the Intergruppo Italiano Linfomi

2005 ◽  
Vol 23 (36) ◽  
pp. 9198-9207 ◽  
Author(s):  
Paolo G. Gobbi ◽  
Alessandro Levis ◽  
Teodoro Chisesi ◽  
Chiara Broglia ◽  
Umberto Vitolo ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Hodgkin’S Lymphoma ◽  
Response Rate ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Free Survival ◽  
Drug Doses ◽  
Advanced Hodgkin’S Lymphoma

Purpose In this multicenter, prospective, randomized clinical trial on advanced Hodgkin's lymphoma (HL), the efficacy and toxicity of two chemotherapy regimens, doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, and prednisone (Stanford V) and mechlorethamine, vincristine, procarbazine, prednisone, epidoxirubicin, bleomycin, vinblastine, lomustine, doxorubicin, and vindesine (MOPPEBVCAD), were compared with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as standard therapy to select which regimen would best support a reduced radiotherapy program, which was limited to ≤ two sites of either previous bulky or partially remitting disease (a modification of the original Stanford program). Patients and Methods Three hundred fifty-five patients with stage IIB, III, or IV HL were randomly assigned. Three hundred thirty-four patients were assessable for the study and received six cycles of ABVD (n = 122), three cycles of Stanford V (n = 107), or six cycles of MOPPEBVCAD (n = 106); radiotherapy was administered to 76, 71, and 50 patients in these three arms, respectively. Results The complete response rates for ABVD, Stanford V, and MOPPEBVCAD were 89%, 76% and 94%, respectively; 5-year failure-free survival (FFS) and progression-free survival rates were 78%, 54%, 81% and 85%, 73%, and 94%, respectively (P < .01 for comparison of Stanford V with the other two regimens). Corresponding 5-year overall survival rates were 90%, 82%, and 89% for ABVD, Stanford V, and MOPPEBVCAD, respectively. Stanford V was more myelotoxic than ABVD but less myelotoxic than MOPPEBVCAD, which had larger reductions in the prescribed drug doses. Conclusion When associated with conditioned and limited (not adjuvant) radiotherapy, ABVD and MOPPEBVCAD were superior to Stanford V chemotherapy in terms of response rate and FFS and progression-free survival. Patients were irradiated less often after MOPPEBVCAD, but this regimen was more toxic. ABVD is still the best choice when it is combined with optional, limited irradiation.

A Phase II Study of Yttrium-90-Ibritumomab Tiuxetan In Combination with a Fludarabine-Based Reduced Intensity Regimen Followed by Allogenic Stem Cell Transplantation In Patients with Relapsed or Chemorefractory CD 20 Positive Non-Hodgkin's Lymphoma.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4565-4565
Author(s):  
Krimo Bouabdallah ◽  
Sabine Furst ◽  
Reda Bouabdallah ◽  
Stephane Vigouroux ◽  
Reza Tabrizi ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Conditioning Regimen ◽  
Hodgkin's Lymphoma ◽  
Unrelated Donor ◽  
Event Free Survival ◽  
Ibritumomab Tiuxetan ◽  
Free Survival ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Bayer Healthcare

Abstract Abstract 4565 Background: The outcome of patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) is very poor despite aggressive treatments or novel therapeutic agents. Allogenic STC (allo-STC) remains the only curative approach with an interesting reduced treatment-related-mortality (TRM) commonly associated with reduced intensity conditioning regimens (RIC). Radio immunotherapy (RIT) as part of conditioning regimen for autologous stem cell transplantion (ASCT) as well as for allo-SCT has demonstrated its safety and many studies are now suggesting an improved outcome. This phase II study (ClinicalTrials.gov: NCT 00607854) evaluated the safety and efficacy of Yttrium-90 ((90)-Y)-ibritumomab tiuxetan in combination with a fludarabine-based RIC followed by allo-SCT in patients with relapsed or chemorefractory CD 20 positive non-Hodgkin's lymphoma. Patients and Method: Patients with relapsed or refractory CD 20 positive NHL where eligible for the study if they had a sensitive disease (at least partial response) to the last salvage regimen and a suitable donor: related (RD) or unrelated donor (MUD or with a C or DQ mismatch). Each patient received a single dose of ((90)-Y)-ibritumomab tiuxetan (0,4 mci/Kg on day -14) followed from day -6 by a combination of fludarabine (30 mg/m2 d -6 to d -2), busilvex ((3,2 mg/Kg d -5 and d -4) and antithymocyte globulin (2,5 mg/Kg d -1). GVH prophylaxis was based on cyclosporine (CsA) alone or in combination with methotrexate (Mtx) in case of mismatched unrelated donor. The trial was designed to enroll 30 evaluable pts and the study started on January 2008. At time of this writing, 27 pts have been included and we report the preliminary results of the first 14 consecutive pts. The primary objective (PO) of the study was to evaluate the day 100 TRM. Secondary objectives were response (CR, PR) and event-free survival at 1 year. RESULTS: Fourteen pts are evaluable for the PO. The median age was 55 years (35-60), and the sex ratio (M/F) 10/4. Prior disease was DLBCL (5), MCL (4), FL (5). Pts received a median number of 2 previous treatment regimens and all pts had undergone ASCT before. Median time between diagnosis and allo-SCT and between ASCT and allo-SCT were 39 mo (range 8 – 106) and 14, 5 mo (range 3–52) respectively. At time of transplant 10 pts were in CR and 4 in PR. There were 10 RD and 4 MUD transplants. All pts received peripheral blood stem cells transplantation and GVH prophylaxis with CsA alone. Two pts died from a-GVH at day 40 and 117 post-transplant respectively with a TRM at day 100 of 7%. Both were in CR. The median time to ANC engraftment (ANC > 500/mm3) was 17 days (range 12 – 22) and time to platelets engraftment (Plt > 20.000/mm3) was 11 days (range 0–16). Acute GVH occurred in 7 pts with only 3 pts with grade ≥ 2. At day 100 after transplantation, 8 out of the 10 (80%) evaluable pts achieved a complete T-cell donor chimerism. With a median follow-up of 10 month (range 6 – 26), 12 pts are alive and in CR. The estimated event-free survival at 1year is 86% (CI 78% - 94%). CONCLUSION: ((90)-Y)-ibritumomab tiuxetan is safe and well tolerated when used in combination with a fludarabine-based RIC regime. Preliminary data suggest that the TRM is not increased by adding RIT in this conditioning regimen. Disclosures: Bouabdallah: Bayer Healthcare: The Trial has been partially sponsored by Bayer Healthcare. Off Label Use: Zevalin is off-label use in conditioning regimen in France.

Update of the FL2000 randomized trial combining rituximab to CHVP-Interferon in follicular lymphoma (FL) patients (pts)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7508-7508 ◽  
Author(s):  
C. Foussard ◽  
N. Mounier ◽  
A. Van Hoof ◽  
V. Delwail ◽  
O. Casasnovas ◽  
...  
Keyword(s):  
Overall Survival ◽  
Randomized Study ◽  
Bone Marrow Involvement ◽  
Risk Groups ◽  
Tumor Burden ◽  
Event Free Survival ◽  
Free Survival ◽  
High Tumor Burden ◽  
Ecog Ps

7508 Background: The GELA-GOELAMS FL2000 trial investigated the role of rituximab in the first line treatment of FL pts. Methods: This prospective randomized study compared the CHVP regimen (12 courses) +18 months α2b-IFN (CHVP-I) to 6 CHVP courses combined with 6 rituximab infusions + 18 months IFN (R-CHVP-I). The primary endpoint was event-free survival (EFS). Inclusion criteria consisted in untreated stage II-IV FL pts; 18–75 years old; with a high tumor burden defined by at least one of the following criteria: B symptoms, ECOG PS>1, LDH>normal value, β2-microglobulin ≥3 mg/L, largest tumor ≥7 cm, 3 distinct nodes ≥3 cm, serous effusion, compression or symptomatic spleen enlargement. Results: From 05/00 until 05/02, 358 eligible pts were randomized (CHVP-I 183 pts and R-CHVP-I 175 pts) with the following characteristics: M/F = 1; median age = 60 years [25–75]; ECOG > 1 = 8%; B symptoms = 27%; AA stage > II = 87%; bone marrow involvement = 58%; β2-m ≥3 mg/L = 31%; LDH > N = 37%; Hb <12 g/dL = 18%; FLIPI score ≥3 in 57% of the pts. The first analysis [ASH 2004] showed a significant better treatment response in R-CHVP-I as compared to CHVP-I and a improvement of event free survival (EFS) in the R-CHVP-I arm (Log-Rang, P = .003). As initially planned, a second analysis on all pts has now been performed with a median follow-up of 3½ years, all pts with data >01/01/05. The median EFS for the whole population has not yet been reached. In the CHVP-I arm, median EFS was 3 years and 46% of the pts are event-free at 42 months (mo.). In contrast, the median has not been reached in the R-CHVP-I arm and the EFS is 67% at 42 mo. (P < .0001). This improvement in EFS was found both in the 150 pts with a low or intermediate FLIPI score (P = .019) and in those (n = 201) with a high score (P = .0005). When considering the 230 pts responders at the end of 18 mo. of therapy, 42 mo. EFS is 62% in CHVP-I arm versus 81% in R-CHVP-I arm (P = .002). Finally, the overall survival at 42 mo. of patients in the CHVP-I arm is of 84% versus to 91% in the R-CHVP-I arm (P = .029) with a reduction of death risk by approximately 2 (RR = 0.55). Conclusions: These results demonstrate that rituximab combined with CHVP-I has a durable benefit, in all FLIPI risk groups, allows to reduce the duration of chemotherapy and improves overall survival in high-tumor burden FL pts. [Table: see text]

scholarly journals Hodgkin's Lymphoma in Children and Adolescents: A Saint Petersburg Hodgkin's Lymphoma Group Study

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Svetlana A. Kulyova ◽  
Boris A. Kolygin
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Risk Group ◽  
Hodgkin's Lymphoma ◽  
Free Survival ◽  
Intermediate Group ◽  
Involved Field ◽  
Prognostic Risk Factors ◽  
Involved Field Radiotherapy ◽  
New Strategies

Purpose. Prospective analysis of the efficacy of the original protocol SPbHL-05 was performed.Patients and Methods. Sixty patients with Hodgkin's lymphoma (HL) aged less than 18 years old were treated in accordance with SPbHL-05 from January 2000, to July 2009. In induction chemotherapy we used VBVP and ABVD schedules followed by involved-field radiotherapy. Fourteen patients (23,3%) with 0–2 adverse factors (the favourable group) received two cycles of chemotherapy (VBVP), 25 children (41,7%) with 3-4 unfavorable signs (the intermediate group) received two cycles of VBVP alternating with two cycles of ABVD, 21 patient (35%) who had 5 or more adverse prognostic factors (the unfavourable group) received three cycles of VBVP alternating with three cycles of ABVD.Results. With a median follow-up of 68 months, overall survival (OS) at 5 years is 91.3%, event-free survival (EFS) is 82.8%. OS in the favourable and intermediate risk group were 100%, EFS were 92,9% and 90,7%, respectively, OS and EFS in unfavourable risk group—77,1% and 55,6%, respectively.Conclusion. The identification of prognostic risk factors and using medicines with less prominent side effects would be of major importance in the development of new strategies of treatment for childhood HL.

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