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Factors of prognostic importance in childhood non‐hodgkin's lymphoma treated with two modified lsa 2 ‐l 2 protocols. A multivariate analysis approach
Author(s) -
De Andrea Maria Lydia,
Franco Eduardo L.,
De Camargo Beatriz,
Alves Antonio Correa,
Machado Jesus C.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19880715)62:2<240::aid-cncr2820620204>3.0.co;2-q
Subject(s) - medicine , regimen , multivariate analysis , logistic regression , stage (stratigraphy) , methotrexate , lymphoma , disease , debulking , performance status , oncology , surgery , cancer , ovarian cancer , paleontology , biology
The results of therapy given to 74 children with advanced disease, abdominal non‐Hodgkin's lymphoma were retrospectively evaluated with respect to the major prognostic factors related to disease outcome. The first 36 patients admitted in the study were treated with a modified LSA 2 ‐L 2 protocol, and the remaining patients received the same regimen with the addition of intermediate‐dose methotrexate (MTX) intravenously during the induction phase (LSA 2 ‐L 2 ‐MTX). The last ten patients admitted were given a leucovorin rescue along with the administration of MTX. The relative efficacy of the LSA 2 ‐L 2 ‐MTX over the baseline LSA 2 ‐L 2 regimen was analyzed by multivariate statistical methods taking into consideration several candidate coprognostic factors. The risk of treatment failure was substantially reduced (55%) with the use of the LSA 2 ‐L 2 ‐MTX regimen. Rescue with leucovorin did not contribute a further significant gain in treatment efficacy, although fewer toxicity‐related problems were observed as compared to the no‐rescue period. Five prognostic factors emerged as significantly explanatory of the risk of treatment failure in addition to protocol type: lymphocyte count, disease stage, surgical debulking, sex, and nutritional status. Based on these variables, a logistic regression equation could be derived to identify groups that were at risk for treatment failure.