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Cancer. 2008 Aug 15;113(4):782-90. doi: 10.1002/cncr.23630.

Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood.

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  • 1Department of Hematology-Oncology, St. Jude Children's Research Hospital, the University of Tennessee at Memphis College of Medicine, Memphis, Tennessee 38105, USA. John.Sandlund@stjude.org

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.

2008 American Cancer Society

PMID:
18618501
[PubMed - indexed for MEDLINE]
PMCID:
PMC2975596
Free PMC Article
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