The impact of the methotrexate administration schedule and dose in the treatment of children and adolescents with B-cell neoplasms: a report of the BFM Group Study NHL-BFM95

Woessmann, Wilhelm; Seidemann, Kathrin; Mann, Georg; Zimmermann, Martin; Burkhardt, Birgit; Oschlies, Ilske; Ludwig, Wolf‐Dieter; Klingebiel, Thomas; Graf, Norbert; Gruhn, Bernd; Juergens, Heribert; Niggli, Felix; Parwaresch, Reza; Gadner, Helmut; Riehm, H; Schrappe, Martin; Reiter, Alfred

doi:10.1182/blood-2004-03-0973

Cited by 313 publications

(313 citation statements)

References 21 publications

(34 reference statements)

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“…Previous study showed a more favorable prognosis of DLBCL in pediatric than adult patients [1,[6][7][8]. In the current study also, the young group had a better event-free and overall survival than the older group, although the difference was not significant.…”

Section: Discussioncontrasting

confidence: 47%

“…While considerable progress has been made in our understanding of the pathogenesis and biology of adult DLBCL patients, data on pediatric DLBCL patients are quite limited. Childhood DLBCL has a more favorable prognosis than DLBCL in adulthood [6][7][8]. The reason for this remains to be clarified: there might be differences in immunophenotypical and cytogenetical characteristics between childhood and adulthood DLBCL.…”

Section: Introductionmentioning

confidence: 99%

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Diffuse large B‐cell lymphoma in the young in Japan: A study by the Osaka Lymphoma Study Group

et al. 2007

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Clinicopathological and immunophenotypical characteristics in 24 patients with diffuse large B-cell lymphoma (DLBCL) under 30 years of age in Osaka, Japan were examined, and the results compared to those of DLBCL patients aged over 40 years in Osaka and of young DLBCL patients in Western countries. The level of LDH and IPI score at initial diagnosis were significantly lower in young than older patients. The sex ratio (M:F) and age range (median) in the young and older groups were 1.18 and 11-30 (24.8) years and 1.59 and 42-87 (62.4) years, respectively. Extranodal presentation was higher in the young group (83.3% versus 60.0%, P < 0.05). Based on immunophenotyping with anti-CD10, bcl-6, and MUM1 antibodies, the cases were categorized as germinal center B-cell (GCB) (CD10+ or CD10-, bcl-6+, MUM1+) or non-GCB phenotype. The frequency of GCB type was significantly lower in the young group than older group (25% vs. 54%, P < 0.05), and much lower than that reported for young patients in Western countries. In situ hybridization revealed one of the young patients to be positive for Epstein-Barr virus (EBV). In the older group, none of 31 cases showed EBV positivity. Three year event-free and overall survival rates of young patients were better than those of the older patients, although not significantly different. DLBCL in the young in Japan is characterized by a much lower frequency of the GCB phenotype compared to that in Western countries. Am. J. Hematol. 82:893-897, 2007. V

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Section: Discussioncontrasting

confidence: 47%

Section: Introductionmentioning

confidence: 99%

Diffuse large B‐cell lymphoma in the young in Japan: A study by the Osaka Lymphoma Study Group

et al. 2007

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“…In a pediatric trial for B-cell neoplasias 5 g/m² MTX given as 4-hour infusion was less toxic than a 24-hour infusion, but-at least in high-risk patients-it was associated with poorer outcome. 22 The situation may change when improved prophylaxis of mucositis, e.g., with keratinocyte growth factor, becomes available. Pediatric trials have underlined the important role of dose intensification of ASP.…”

Section: Bothmentioning

confidence: 99%

Treatment of Adult Acute Lymphoblastic Leukemia

Gökbuget¹,

Hoelzer²

2006

Hematology

136

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In the early 1980s, adult acute lymphoblastic leukemia (ALL) was a rarely curable disease with overall survival < 10%. After adapting combinations employed by pediatric groups, the outcome improved to 30-40%. A period of stagnation followed with improvement only in distinct subgroups. In the past 5 years, however, striking new developments have been noticeable. Progress has been made in molecular diagnostics of ALL. Improvements to standard therapy including stem cell transplantation (SCT) have occurred and a variety of new drugs for ALL are under evaluation. Rapid diagnosis and classification of ALL is increasingly important to identify prognostic factors and molecular genetic subsets that will be the focus of "targeted" therapies as we enter the era of subset specific treatment. In the following review we will discuss treatment of adult ALL (excluding elderly patients, 1 adolescents 2 and patients with Ph/BCR-ABL positive ALL 3 ). Standard Treatment of Adult ALLIn the past decade two basic types of prospective trials have been reported in adult acute lymphoblastic leukemia (ALL) ( Table 1). One is dedicated to comparative analysis of the role of stem cell transplantation (SCT) with allogeneic SCT in all patients with sibling donors 4,5,6,7 ; the other group consists of studies focused on optimization of chemotherapy with SCT only for subgroups such as Philadelphia chromosome (Ph)-positive ALL 8,9 or based on prognostic models. [10][11][12][13][14] Complete response (CR) rates ranged between 74% and 93% and the overall survival (OS) between 27% and 48%. No difference is evident for OS of studies focused on SCT (N = 2696), with a weighted mean of 84% for CR and 35% for OS, 4-7 and studies with riskadapted approaches (N = 2443), with mean CR rate of 83% and OS of 36%. [10][11][12][13][14]8 Notably, only a few studies included patients aged above 60 years. 6,[9][10][11]13 Induction therapy Standard induction of adult ALL includes at least a glucocorticoid, vincristine, an anthracycline and probably asparaginase. In response to pediatric results that show a decreased central nervous system (CNS) relapse rate and improved survival, 15 prednisone is now being replaced by dexamethasone. The dexamethasone schedule has to be considered carefully since continuous application of higher doses may lead to long-term complications such as avascular bone necrosis 15 and to increased morbidity and mortality due to infections. The German Multicenter Study Group (GMALL) observed in their pilot trial 06/99 an early mortality of 16% with dexamethasone 10 mg/m² given on days 1-16 compared to 5% for an interrupted schedule (days 1-5,11-14) with corresponding CR rates of 76% and 82%. 16 The most frequently used anthracycline is daunorubicin (DNR). One randomized study showed a diseasefree survival of 36% for DNR at 30 mg/m² compared to 30% for idarubicin (9 mg/m²) given weekly in induction. 14 Many groups have replaced weekly applications by higher doses of DNR (45-80 mg/m²) on subsequent days. Promising results of smaller trials have...

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“…With adequate therapy, about 80-90% of the patients with mature B-cell malignancies can now become long-term, disease-free survivors. 1 However, the prognosis of children who suffer from a relapse is still very poor. In most therapy studies, risk stratification for mature B-cell NHL is largely based on stage of disease and the initial serum lactate dehydrogenase level.…”

mentioning

confidence: 99%

CD44 deficiency is a consistent finding in childhood Burkitt's lymphoma and leukemia

et al. 2007

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The impact of the methotrexate administration schedule and dose in the treatment of children and adolescents with B-cell neoplasms: a report of the BFM Group Study NHL-BFM95

Cited by 313 publications

References 21 publications

Diffuse large B‐cell lymphoma in the young in Japan: A study by the Osaka Lymphoma Study Group

Diffuse large B‐cell lymphoma in the young in Japan: A study by the Osaka Lymphoma Study Group

Treatment of Adult Acute Lymphoblastic Leukemia

CD44 deficiency is a consistent finding in childhood Burkitt's lymphoma and leukemia

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