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Combination of dexamethasone, high‐dose cytarabine, and carboplatin is effective for advanced large‐cell non‐Hodgkin lymphoma of childhood
Author(s) -
Sandlund John T.,
Santana Victor M.,
Hudson Melissa M.,
Onciu Mihaela,
Head David,
Murry Daryl J.,
Ribeiro Raul,
Wallace Dana,
Rencher Renee,
Pui ChingHon
Publication year - 2008
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/cncr.23630
Subject(s) - medicine , vincristine , regimen , carboplatin , cytarabine , cyclophosphamide , dexamethasone , oncology , prednisone , gastroenterology , chemotherapy , surgery , cisplatin
Abstract BACKGROUND. The purpose of the current study was to evaluate the activity and toxicity of dexamethasone, high‐dose cytarabine, and carboplatin (DAC) combination therapy in children with newly diagnosed large‐cell non‐Hodgkin lymphoma (NHL) and to estimate the event‐free and overall survival rates achieved when DAC is incorporated into a conventional regimen. METHODS. From 1991 to 1997, 20 boys and 5 girls aged 4.2 to 17.7 years who had stage III (according to the St. Jude staging system) (n = 21) or stage IV (n = 4) large‐cell NHL were treated in this study. DAC therapy was administered at the beginning of the induction phase in 2 sequential cycles and incorporated throughout a continuation phase (modified from the ACOP+ regimen, which features doxorubicin, cyclophosphamide, vincristine, and prednisone) with doxorubicin, cyclophosphamide, vincristine, and dexamethasone. The total duration of treatment was approximately 10 months. RESULTS. DAC therapy yielded a response in 22 of 25 patients (88%; 95% confidence interval [95% CI], 68%‐97%): complete remission in 13 cases (52%), and partial response in 9 (36%). After additional treatment with doxorubicin, cyclophosphamide, vincristine, and dexamethasone, complete remission was attained in 18 patients (72%) and partial remission in 3 (12%). The event‐free survival rate (± the standard error [SE]) was 64% ± 9% and the overall survival rate was 80% ± 8% at 5 years. CONCLUSIONS. The results of the current study indicate that the DAC regimen is well tolerated and effective for pediatric patients with large‐cell NHL. Cancer 2008. © 2008 American Cancer Society.