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Lymphoma

Effective treatment of advanced-stage childhood lymphoblastic lymphoma without prophylactic cranial irradiation: results of St Jude NHL13 study

Leukemia volume 23, pages 1127–1130 (2009)Cite this article

Abstract

There has been a steady improvement in cure rates for children with advanced-stage lymphoblastic non-Hodgkin's lymphoma. To further improve cure rates whereas minimizing long-term toxicity, we designed a protocol (NHL13) based on a regimen for childhood T-cell acute lymphoblastic leukemia, which features intensive intrathecal chemotherapy for central –nervous system-directed therapy and excludes prophylactic cranial irradiation. From 1992 to 2002, 41 patients with advanced-stage lymphoblastic lymphoma were enrolled on the protocol. Thirty patients had stage III and 11 had stage IV disease. Thirty-three cases had a precursor T-cell immunophenotype, five had precursor B-cell immunophenotype and in three immunophenotype was not determined. Out of the 41 patients, 39 (95%) achieved a complete remission. The 5-year event-free rate was 82.9±6.3% (s.e.), and 5-year overall survival rate was 90.2±4.8% (median follow-up 9.3 years (range 4.62–13.49 years)). Adverse events included two induction failures, one death from typhlitis during remission, three relapses and one secondary acute myeloid leukemia. The treatment described here produces high cure rates in children with lymphoblastic lymphoma without the use of prophylactic cranial irradiation.

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Acknowledgements

We thank the patients and their families. We thank Renee Rencher for data collection. We also thank Sharon Naron for scientific editing. This work was supported in part by a grant from the National Cancer Institute (CA 21765), and by the American Lebanese Syrian Associated Charities (ALSAC).

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Authors and Affiliations

  1. Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA

    J T Sandlund, C-H Pui, B I Razzouk, N Hijiya, D Campana, M M Hudson & R C Ribeiro

  2. Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA

    Y Zhou

  3. Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA

    F G Behm, M Onciu & D Campana

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  1. J T Sandlund
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  2. C-H Pui
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  3. Y Zhou
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  4. F G Behm
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  5. M Onciu
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  6. B I Razzouk
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  7. N Hijiya
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  8. D Campana
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  9. M M Hudson
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  10. R C Ribeiro
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Correspondence to J T Sandlund.

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Sandlund, J., Pui, CH., Zhou, Y. et al. Effective treatment of advanced-stage childhood lymphoblastic lymphoma without prophylactic cranial irradiation: results of St Jude NHL13 study. Leukemia 23, 1127–1130 (2009). https://doi.org/10.1038/leu.2008.400

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