Intensive chemotherapy for non-localised Burkitt's lymphoma.

Al-Attar, A.; Pritchard, Jon; Al‐Saleem, Tahseen; Alnaimi, Mona I; Alash, N.; Attra, A

doi:10.1136/adc.61.10.1013

Cited by 23 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six new cases received a multidrug (8 drugs) protocol of rotating chemotherapy as described in 1986 1201. This regimen included the following drugs: CTX, adriamycin, VCR, prednisone, MTX, VM 26, 6-thioguanine, and cytosine arabinoside [20]. Radiotherapy was not a part of primary treatment, but 11 children received cobalt therapy for local control of recurrent tumors.…”

Section: Methodsmentioning

confidence: 99%

Burkitt's lymphoma between African and American types in Turkish children: Clinical, viral (EBV), and molecular studies

Çavdar

Gözdaşoĝlu

Yavuz

et al. 1993

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

Seventy-two Turkish children with Burkitt's lymphoma (BL) observed during a period of 22 years (1968-1990) have been analysed retrospectively. The diagnosis was established histologically according to WHO criteria. BL represented 50% of NHL in this series. The patients were staged according to Ziegler's system. The median age of patients was 5.5 years with a sex (M/F) ratio of 2.1/1. The most common primary site of tumor involvement was the abdomen (69.4%), which was followed by facial tumors, in particular the jaw and orbit (49.9%). There were 21 cases with jaw (29.1%) and 15 cases with orbital involvement (20.8%) at initial presentation. The majority of the patients (84.4%) were in advanced stages (C and D) at initial diagnosis. Facial tumors observed in Turkish children with BL were more similar to African Burkitt's lymphoma than American or European cases. High titers of antibodies against VCA and EA of EBV were also seen in our recent cases of BL. Two main treatment regimens, namely, single agent chemotherapy with cyclophosphamide (CYX) (1968-1974) and three drug (COM) combination chemotherapy, were used consecutively (1974-1988). COM has been shown to produce better results than single agent therapy. The clinical presentation, mean age, and high antibodies (IgG) to EBV and preliminary molecular studies revealed that BL appears to be in between African and non-African types in Turkish children. This will be further elucidated by direct examination of tumor cells for EBV and investigation of the molecular characteristics of Turkish tumors. Such studies are presently under way.

show abstract

Section: Methodsmentioning

confidence: 99%

Burkitt's lymphoma between African and American types in Turkish children: Clinical, viral (EBV), and molecular studies

Çavdar

Gözdaşoĝlu

Yavuz

et al. 1993

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

show abstract

“…However, we felt that the early mortality could be reduced by more careful attention to supportive care during the first two weeks of therapy, when our patients' poor nutritional status (Al-Attar et al, 1986) was compounded by urate nephropathy and other biochemical effects of the 'tumour lysis syndrome'. In addition, a number of children had had early, and possibly unnecessary, 'debulking' surgery before transfer to our unit: before BL study II we encouraged our surgical colleagues to refer patients to us before laparotomy -a policy adhered to in 22/24 cases.…”

Section: Discussionmentioning

confidence: 99%

“…All children received the GRAB regime, exactly as described in Al-Attar et al (1986). There was no radiotherapy.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

'Debulking' surgery is unnecessary in advanced abdominal Burkitt lymphoma in Iraq

Al-Attar

Attra²,

al-Bagdadi³

et al. 1989

Br J Cancer

Self Cite

View full text Add to dashboard Cite

“…The cure rate has increased from less than 20% before 1980 (Al-Attar et al, 1979) to over 70% in the 1980s and 1990s (Philip et al, 1982;Al-Attar et al, 1986;Patte et al, 1990). Recent studies have concentrated on improving outcome in the remaining poor-risk subgroups (Hann et al, 1988;Patte et al, 1991;Cairo et al, 1996), reducing early deaths by aggressive treatment of early renal and infectious complications (Lynch et al, 1977;Allegretta et al, 1985) and avoiding debulking surgery (Frappaz et al, 1988;Al-Attar et al, 1989).…”

mentioning

confidence: 99%

Improved cure rate in children with B-cell acute lymphoblastic leukaemia (B-ALL) and stage IV B-cell non-Hodgkin's lymphoma (B-NHL) - results of the UKCCSG 9003 protocol

Atra

Gerrard²,

Hobson³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

Improved cure rate in children with B-cell acute lymphoblastic leukaemia (B-ALL) February 1996, 35 patients with B-cell acute lymphoblastic leukaemia (B-ALL) 13 of whom had CNS disease and 28 patients with stage IV B-cell non-Hodgkin's lymphoma (B-NHL) 22 of whom had CNS involvement were treated with a short, intensive multiagent chemotherapy regimen (UKCCSG 9003 protocol) based on the French LMB 86 regimen. Fifty-five were boys. The age range was 11 months to 16.5 years (median 8.4 years). Chemotherapy included cyclophosphamide, vincristine, daunorubicin, high-dose methotrexate (COPADM) and etoposide/high-dose cytarabine (CYVE) with frequent intrathecal (i.t.) triple therapy (methotrexate, cytarabine and hydrocortisone). Cranial irradiation (24 Gy in 15 fractions) was recommended in patients with overt CNS disease. One patient with WiskottAldrich syndrome was withdrawn after entry and has been excluded from the analysis. Ten patients (16%) have relapsed (CNS, four; BM, two; combined CNS and BM, three; and jaw, one) 4-11 months after diagnosis and two patients never achieved complete remission (CR). All have died. In seven of the patients who relapsed, treatment had been modified or delayed because of poor clinical condition. Seven patients (11 %) died of toxicity 11 days to 4 months after diagnosis. The cause of death was sepsis (n = 5) or sepsis with renal failure (n = 2). With a median follow-up of 3.1 years from diagnosis (range 9 months to 6.3 years), 43 patients (69%) survive in CR. This study confirms the effectiveness of this regimen with regard to the relapse rate (16%), although the rate of toxic death is of concern.Keywords: high risk; paediatric cancer; B-cell acute lymphoblastic leukaemia; B-cell non-Hodgkin's lymphomaThe treatment of B-NHL in children is one of the success stories in paediatric oncology. The cure rate has increased from less than 20% before 1980 (Al-Attar et al, 1979) to over 70% in the 1980s and 1990s (Philip et al, 1982;Al-Attar et al, 1986;Patte et al, 1990). Recent studies have concentrated on improving outcome in the remaining poor-risk subgroups (Hann et al, 1988;Patte et al, 1991;Cairo et al, 1996), reducing early deaths by aggressive treatment of early renal and infectious complications (Lynch et al, 1977;Allegretta et al, 1985) and avoiding debulking surgery (Frappaz et al, 1988;Al-Attar et al, 1989).In 1986, the French paediatric oncology group (SFOP) introduced a regimen for poor-risk patients with increased intensity of early intrathecal (i.t.) therapy and the use of high-dose cytarabine (LMB 86). Before this, results in patients with CNS disease were disappointing, despite the use of craniospinal irradiation with chemotherapy regimen, which was very effective in less advanced disease (Philip et al, 1982;Chilcote et al, 1991). The subsequent results with LMB 86 were dramatic, with a survival rate over 70% (Rubie et al, 1988). Relapse of the underlying disease remains a major cause of treatment failure. The use of high-dose cytarabine and etoposide (CYVE) may he...

show abstract

Intensive chemotherapy for non-localised Burkitt's lymphoma.

Cited by 23 publications

References 17 publications

Burkitt's lymphoma between African and American types in Turkish children: Clinical, viral (EBV), and molecular studies

Burkitt's lymphoma between African and American types in Turkish children: Clinical, viral (EBV), and molecular studies

'Debulking' surgery is unnecessary in advanced abdominal Burkitt lymphoma in Iraq

Improved cure rate in children with B-cell acute lymphoblastic leukaemia (B-ALL) and stage IV B-cell non-Hodgkin's lymphoma (B-NHL) - results of the UKCCSG 9003 protocol

Contact Info

Product

Resources

About