Results of LSA2-L2 therapy in 26 children with non-hodgkin's lymphoma

Abstract

Twenty‐six children with non‐Hodgkin's lymphoma (NHL), 17 boys and nine girls, were treated with the LSA2‐L2 protocol. Seven children had Stage I or II, 16 Stage III and three Stage IV according to Murphy's staging system. Eight children had their primaries in peripheral lymph nodes, eight in the abdomen, six in the mediastinum and four in other sites. All tumors were classified histologically according to four different classifications. Overall disease‐free actuarial survival is 53.6%. Complete responders show a disease‐free survival of 77.8%. Fourteen children survived for 9–56 months. Included are all seven children with Stage I or II who survive irrespective of histologic type of the tumor. Of the remaining 12 children in Stage III or IV three children died in remission and nine of progressive disease. Eight of these nine patients did not attain complete remission. Whereas four of five children with the convoluted type of NHL survive, four of five patients with the Burkitt's type (small noncleaved follicle center cell lymphomas) died of progressive disease. According to Rappaport's classification, four of six children with diffuse undifferentiated lymphoma (DUL) are dead due to tumor progression. Considering the classification of lymphoblastic lymphomas introduced by Nathwani et al.,23 five of seven children suffering from lymphoblastic lymphomas but only two of eight children with nonlymphoblastic lymphomas belong to the survivors. Therefore histologic findings do hold prognostic sigicance in our series of children with NHL.

Primary non-Hodgkin's lymphoma of the liver, successful management with LSA2-L2chemotherapy and local irradiation in a 13-year-old boy

“…Five days after diagnosis therapy was started using the LSA2-L2 protocol (6-Thioguanin and BCNU were not available at that time and had to be replaced by 6-mercaptopurine and cyclophosphamide) (1-3, 13,15). Already during the induction chemotherapy liverspleen scan follow-up studies showed a reduction of the liver size and a decrease of portal vein occlusion.…”

Autologous bone marrow transplantation in the treatment of children and adolescents with advanced malignant tumors

“…The two year failure-free survival of the patient group with nonlocalized, nonlymphoblastic NHL (the majority of them having the primary site in the abdomen) was only 57% on the COMP and only 25 % on the LSA2-Lz regimen. These findings are supported by a smaller study performed by Pichler et a1 [30]. They have treated 26 children according to the LSA2-L2 protocol of Wollner.…”

Malignant lymphomas in children and adolescents

“…Cure rates are still poor for children with diffuse, undifferentiated histologies who present with widespread disease [94,95]. The application of leukemia-type treatments in these patients has been relatively unsuccessful.…”