Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92)

Marta Pillon, Maria Teresa Di Tullio, Alberto Garaventa, Simone Cesaro, Maria Caterina Putti, Claudio Favre, Alma Lippi, Gianmarco Surico, Andrea Di Cataldo, Emanuele D'Amore, Lulgi Zanesco, Angelo Rosolen

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Abstract

BACKGROUND. Childhood B-cell lymphomas (B-NHLs) represent a group of aggressive malignancies that are amenable to high-intensity chemotherapy regimens. In 1992, the Italian Association of Pediatric Hematology and Oncology (AIEOP) initiated a prospective clinical trial involving the diagnosis and treatment of childhood B-NHL based on a well established strategy developed by the Berlin-Frankfurt-Munster Group. METHODS. Between November 1992 and October 1997, 163 children who had B-NHL were treated prospectively in the first national AIEOP trial. Disease staging was performed according to the St. Jude staging system, and treatment was assigned on the basis of risk group (R1, R2, or R3), which took into account disease stage and resectability and serum lactate dehydrogenase (LDH) levels. RESULTS. Of the 144 evaluable patients, 11 had Stage I disease, 35 had Stage II disease, 76 had Stage III disease, and 22 had Stage IV disease. Thirteen, 54, and 77 patients were included in risk groups R1, R2, and R3, respectively. The 10-year overall survival (OS) and event-free survival (EFS) rates for the overall population were 89.4% and 81.8%, respectively; the EFS rates for patients in risk groups R1, R2, and R3 were 100%, 86.9%, and 75.1%, respectively. Multivariate analysis indicated that age ≥ 10 years, disease histology other than Burkitt or Burkitt-like lymphoma, and LDH levels ≥ 1000 international units per liter had negative prognostic value. Analysis of the toxicity (according to the World Health Organization grading system) associated with 710 of the 748 chemotherapy cycles administered revealed 855 cases of Grade 3 or 4 toxicity, with 73% being cases of hematologic toxicity. Toxic episodes were most common after the first chemotherapy cycle and were equally common in the R2 and R3 risk groups. To date, the development of a second malignancy has not been observed in any patient in the study cohort. CONCLUSIONS. Long-term follow-up of the current study (AIEOP LNH92) confirms the observation of a favorable outcome for patients with B-NHL treated with short, intensive chemotherapy regimens and raises the possibility that non-Burkitt or non-Burkitt-like histology and age ≥ 10 years may have negative prognostic value for patients with childhood B-NHL.

Original languageEnglish
Pages (from-to)385-394
Number of pages10
JournalCancer
Volume101
Issue number2
DOIs
Publication statusPublished - Jul 15 2004

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B-Cell Lymphoma
Hematology
Clinical Protocols
Non-Hodgkin's Lymphoma
Pediatrics
Drug Therapy
L-Lactate Dehydrogenase
Disease-Free Survival
Histology
Survival Rate
Burkitt Lymphoma
Second Primary Neoplasms
Poisons
Berlin
Cohort Studies
Multivariate Analysis
Observation
Clinical Trials
Survival
Therapeutics

Keywords

  • B-cell NHL
  • Burkitt lymphoma
  • Child
  • Non-Hodgkin lymphoma
  • Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92). / Pillon, Marta; Di Tullio, Maria Teresa; Garaventa, Alberto; Cesaro, Simone; Putti, Maria Caterina; Favre, Claudio; Lippi, Alma; Surico, Gianmarco; Di Cataldo, Andrea; D'Amore, Emanuele; Zanesco, Lulgi; Rosolen, Angelo.

In: Cancer, Vol. 101, No. 2, 15.07.2004, p. 385-394.

Research output: Contribution to journalArticle

Pillon, M, Di Tullio, MT, Garaventa, A, Cesaro, S, Putti, MC, Favre, C, Lippi, A, Surico, G, Di Cataldo, A, D'Amore, E, Zanesco, L & Rosolen, A 2004, 'Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92)', Cancer, vol. 101, no. 2, pp. 385-394. https://doi.org/10.1002/cncr.20382
Pillon, Marta ; Di Tullio, Maria Teresa ; Garaventa, Alberto ; Cesaro, Simone ; Putti, Maria Caterina ; Favre, Claudio ; Lippi, Alma ; Surico, Gianmarco ; Di Cataldo, Andrea ; D'Amore, Emanuele ; Zanesco, Lulgi ; Rosolen, Angelo. / Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92). In: Cancer. 2004 ; Vol. 101, No. 2. pp. 385-394.
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abstract = "BACKGROUND. Childhood B-cell lymphomas (B-NHLs) represent a group of aggressive malignancies that are amenable to high-intensity chemotherapy regimens. In 1992, the Italian Association of Pediatric Hematology and Oncology (AIEOP) initiated a prospective clinical trial involving the diagnosis and treatment of childhood B-NHL based on a well established strategy developed by the Berlin-Frankfurt-Munster Group. METHODS. Between November 1992 and October 1997, 163 children who had B-NHL were treated prospectively in the first national AIEOP trial. Disease staging was performed according to the St. Jude staging system, and treatment was assigned on the basis of risk group (R1, R2, or R3), which took into account disease stage and resectability and serum lactate dehydrogenase (LDH) levels. RESULTS. Of the 144 evaluable patients, 11 had Stage I disease, 35 had Stage II disease, 76 had Stage III disease, and 22 had Stage IV disease. Thirteen, 54, and 77 patients were included in risk groups R1, R2, and R3, respectively. The 10-year overall survival (OS) and event-free survival (EFS) rates for the overall population were 89.4{\%} and 81.8{\%}, respectively; the EFS rates for patients in risk groups R1, R2, and R3 were 100{\%}, 86.9{\%}, and 75.1{\%}, respectively. Multivariate analysis indicated that age ≥ 10 years, disease histology other than Burkitt or Burkitt-like lymphoma, and LDH levels ≥ 1000 international units per liter had negative prognostic value. Analysis of the toxicity (according to the World Health Organization grading system) associated with 710 of the 748 chemotherapy cycles administered revealed 855 cases of Grade 3 or 4 toxicity, with 73{\%} being cases of hematologic toxicity. Toxic episodes were most common after the first chemotherapy cycle and were equally common in the R2 and R3 risk groups. To date, the development of a second malignancy has not been observed in any patient in the study cohort. CONCLUSIONS. Long-term follow-up of the current study (AIEOP LNH92) confirms the observation of a favorable outcome for patients with B-NHL treated with short, intensive chemotherapy regimens and raises the possibility that non-Burkitt or non-Burkitt-like histology and age ≥ 10 years may have negative prognostic value for patients with childhood B-NHL.",
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T1 - Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92)

AU - Pillon, Marta

AU - Di Tullio, Maria Teresa

AU - Garaventa, Alberto

AU - Cesaro, Simone

AU - Putti, Maria Caterina

AU - Favre, Claudio

AU - Lippi, Alma

AU - Surico, Gianmarco

AU - Di Cataldo, Andrea

AU - D'Amore, Emanuele

AU - Zanesco, Lulgi

AU - Rosolen, Angelo

PY - 2004/7/15

Y1 - 2004/7/15

N2 - BACKGROUND. Childhood B-cell lymphomas (B-NHLs) represent a group of aggressive malignancies that are amenable to high-intensity chemotherapy regimens. In 1992, the Italian Association of Pediatric Hematology and Oncology (AIEOP) initiated a prospective clinical trial involving the diagnosis and treatment of childhood B-NHL based on a well established strategy developed by the Berlin-Frankfurt-Munster Group. METHODS. Between November 1992 and October 1997, 163 children who had B-NHL were treated prospectively in the first national AIEOP trial. Disease staging was performed according to the St. Jude staging system, and treatment was assigned on the basis of risk group (R1, R2, or R3), which took into account disease stage and resectability and serum lactate dehydrogenase (LDH) levels. RESULTS. Of the 144 evaluable patients, 11 had Stage I disease, 35 had Stage II disease, 76 had Stage III disease, and 22 had Stage IV disease. Thirteen, 54, and 77 patients were included in risk groups R1, R2, and R3, respectively. The 10-year overall survival (OS) and event-free survival (EFS) rates for the overall population were 89.4% and 81.8%, respectively; the EFS rates for patients in risk groups R1, R2, and R3 were 100%, 86.9%, and 75.1%, respectively. Multivariate analysis indicated that age ≥ 10 years, disease histology other than Burkitt or Burkitt-like lymphoma, and LDH levels ≥ 1000 international units per liter had negative prognostic value. Analysis of the toxicity (according to the World Health Organization grading system) associated with 710 of the 748 chemotherapy cycles administered revealed 855 cases of Grade 3 or 4 toxicity, with 73% being cases of hematologic toxicity. Toxic episodes were most common after the first chemotherapy cycle and were equally common in the R2 and R3 risk groups. To date, the development of a second malignancy has not been observed in any patient in the study cohort. CONCLUSIONS. Long-term follow-up of the current study (AIEOP LNH92) confirms the observation of a favorable outcome for patients with B-NHL treated with short, intensive chemotherapy regimens and raises the possibility that non-Burkitt or non-Burkitt-like histology and age ≥ 10 years may have negative prognostic value for patients with childhood B-NHL.

AB - BACKGROUND. Childhood B-cell lymphomas (B-NHLs) represent a group of aggressive malignancies that are amenable to high-intensity chemotherapy regimens. In 1992, the Italian Association of Pediatric Hematology and Oncology (AIEOP) initiated a prospective clinical trial involving the diagnosis and treatment of childhood B-NHL based on a well established strategy developed by the Berlin-Frankfurt-Munster Group. METHODS. Between November 1992 and October 1997, 163 children who had B-NHL were treated prospectively in the first national AIEOP trial. Disease staging was performed according to the St. Jude staging system, and treatment was assigned on the basis of risk group (R1, R2, or R3), which took into account disease stage and resectability and serum lactate dehydrogenase (LDH) levels. RESULTS. Of the 144 evaluable patients, 11 had Stage I disease, 35 had Stage II disease, 76 had Stage III disease, and 22 had Stage IV disease. Thirteen, 54, and 77 patients were included in risk groups R1, R2, and R3, respectively. The 10-year overall survival (OS) and event-free survival (EFS) rates for the overall population were 89.4% and 81.8%, respectively; the EFS rates for patients in risk groups R1, R2, and R3 were 100%, 86.9%, and 75.1%, respectively. Multivariate analysis indicated that age ≥ 10 years, disease histology other than Burkitt or Burkitt-like lymphoma, and LDH levels ≥ 1000 international units per liter had negative prognostic value. Analysis of the toxicity (according to the World Health Organization grading system) associated with 710 of the 748 chemotherapy cycles administered revealed 855 cases of Grade 3 or 4 toxicity, with 73% being cases of hematologic toxicity. Toxic episodes were most common after the first chemotherapy cycle and were equally common in the R2 and R3 risk groups. To date, the development of a second malignancy has not been observed in any patient in the study cohort. CONCLUSIONS. Long-term follow-up of the current study (AIEOP LNH92) confirms the observation of a favorable outcome for patients with B-NHL treated with short, intensive chemotherapy regimens and raises the possibility that non-Burkitt or non-Burkitt-like histology and age ≥ 10 years may have negative prognostic value for patients with childhood B-NHL.

KW - B-cell NHL

KW - Burkitt lymphoma

KW - Child

KW - Non-Hodgkin lymphoma

KW - Therapy

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U2 - 10.1002/cncr.20382

DO - 10.1002/cncr.20382

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