Improved prognosis in children with intra-abdominal non-Hodgkin's lymphoma following LSA2L2 protocol chemotherapy

Abstract

Thirty-five consecutive, previously untreated patients with intra-abdominal non-Hodgkin's lymphoma (IANHL), seen between January 1971 and June 1978, were entered on the LSA2-L2 protocol. Six patients had Stage II disease, 23 Stage III and six Stage IV. The prevalent histologic types were diffuse lymphocytic poorly differentiated (13 patients) and diffuse undifferentiated (13 patients) followed by diffuse histiocytic (5 patients) and diffuse lymphoblastic (2 patients). All patients received LSA2-L2 protocol chemotherapy. Three of 4 patients with gross residual disease following initial surgery, who were seen prior to 1974, received radiation therapy during induction chemotherapy; there were no survivors among these 3 patients. Our treatment plan was revised in 1974 to include a "second-look" laparotomy during the third week of induction chemotherapy for all patients with gross residual intra-abdominal disease following their initial surgery. The disease-free actuarial survival for the total group of 35 patients is 72%. Fifteen of the 26 surviving patients are off therapy and have shown no evidence of recurrence or metastases (median observation time 26 + months). Fifteen of 26 patients seen after 1973 underwent the second laparotomy and only two were found to have residual disease. The LSA2-L2 protocol has significantly improved the disease-free survival rate of children with IANHL, even with widespread intra-abdominal and extra-abdominal disease at diagnosis. Further, the "second-look" laparotomy in patients with large unresectable disease at presentation has proved a useful method of unequivocal evaluation of response, thus eliminating unnecessary extensive abdominal irradiation in many of these children.

Burkitt-type lymphoma in France among non-Hodgkin malignant lymphomas in Caucasian children

“…CSF involvement is usually sent to the Centre Leon Berard. early complication, especially in It is quite surprising to read the recent ats with extensive disease, and oc-report by Wollner et al (1980) of 35 d in 6/29 cases at 1-4 months of abdominal lymphomas in children, indition. Later, there may be local cating that none of them was a BL.…”

“…In large series of childhood nonHodgkin malignant lymphomas (NHML) outside the endemic region, BL was reported to account for from 0% (Wollner et al, 1980) to 45.6% (Gerard-Marchant et al, 1982).…”

Improved Survival of Children with Non-Hodgkin's Lymphoma with Intermediate Dose Methotrexate, Intrathecal Methotrexate, and Citrovorum Factor Rescue

“…Site of origin and histology have been reported to influence prognosis by most authors except Wollner et al 1 Tcell mediastinal lymphoma is believed to carry a worse prognosis. The eight patients who failed (Table 4) in Group III form a heterogeneous group and therefore no risk factors could be identified.…”

“…[1][2][3][4] Research has been hampered by the relative infrequency of this disease in the Western world, multiplicity of its sites, lack of a universally accepted classification system, and geographical differences in the clinical behavior of the disease. 5,6 Obstacles to cure continue to be latestage disease at the time of diagnosis, conversion to leukemia and involvement of the central nervous system (CNS).…”

Outcome of children and adolescents with lymphoblastic lymphoma

“…19 After 1987, patients were treated with a BFM-83-based protocol (Berlin-Frankfurt-Münster). 20 • Response criteria: complete remission (CR) was defined as the disappearance of all tumor masses confirmed by clinical examination and imaging investigations, one month after therapy.…”