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ctt-journal > Shelikhova et al. (Abstract)

Shelikhova et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract07
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Current treatment of mature B-NHL/ALL in children and adolescents in regional pediatric clinics of the Russian Federation

Larisa N. Shelikhova, Natalia V. Myakova, Alexey A. Maschan, Elena V. Samochatova

Federal Research Center for Pediatric Hematology/Oncology and Immunology, Moscow, RF

Correspondence: Larisa N. Shelikhova, Federal Research Center for Pediatric Hematology/Oncology and Immunology, 117/2, Leninsky prospect, 117997, Moscow, RF, E-mail: lnik1976@spam is badmail.ru, samochatova@spam is badniidg.ru

Abstract

Background: To evaluate the effectiveness and toxicity of 2 therapy regimens for children and adolescents with mature B-NHL used over the last 10 years in specialized clinics of hematology/oncology in the Russian Federation (St. Petersburg, Ekaterinburg, N. Novgorod, Balashikha, Makhachkala, Chelyabisk, Orenburg, Kirov, Rostov-Don, Cheboksari, Novokuznetsk, Arkhangelsk, Perm, Astrakhan, Jaroslavl, Rjazan, Blagoveschensk, and Moscow, Ufa). One regimen is based on original and modified B-NHL 90 and 95. The other is a regimen combining rituximab and less intensive CT with a decreased dose of Mtx (protocol B-NHL 2004mab).

Objectives: To propose a standardized program of treatment for children and adolescents with mature B-NHL which could be effectively used in the majority of pediatric specialized hospitals of the Russian Federation (RF.)

Methods: A database that included information from 28 pediatric departments of hematology/oncology followed by standard statistical analysis.

Results: From January 2004 until April 2010, 233 untreated patients with mature B-NHL (BL/B-ALL, 143/40 pts; DLBCL, 66 pts) were enrolled in a trial: m:f = 3:1, with a median age of 9.5 years. 132 pts received the B-NHL-2004m protocol, 101 pts received NHL- BFM-90 or 95. With a med. FU of 38 mo. (3–70), CR was achieved in 92 and 82% of pts, RFS was 0.95 and 0.91; and EFS and OS were 0.86±0.04 and 0.72±0.06 (p=<0.05), respectively. Toxic deaths were the main cause of failure in the BFM-oriented type of treatment.

Conclusions: Rituximab combined with conventional CT is a well-tolerated regimen, associated with excellent results. This therapy can be recommended as the first-line treatment for pediatric mature B-NHL/B-ALL. Future studies are required to determine the optimal dose of chemotherapy and rituximab for agressive NHL for maximum effectiveness with minimal acute and late toxicity. 
             
Keywords: non-Hodgkin lymphoma, combined treatment, rituximab, children

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