Anaplastic large cell lymphoma in childhood: analysis of 72 patients treated on The United Kingdom Children's Cancer Study Group chemotherapy regimens

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Abstract

From June 1990 to June 1998, 72 patients with anaplastic large cell lymphoma (ALCL) were treated with short intensive multi-agent regimens [non-Hodgkin's lymphoma (NHL) 9000 and 9602]. Diagnosis was based on morphological and immunophenotypic criteria. Treatment for stage I disease consisted of eight courses (2 x vincristine, doxorubicin, prednisolone; 2 x methotrexate; 2 x cytarabine, thioguanine; and 2 x methotrexate etoposide). For stage II, III and non-central nervous system (CNS) stage IV, two COPADM (cyclophosphamide, doxorubicin, prednisolone, methotrexate, vincristine), two CYM (cytarabine methotrexate) and a COPADM was given. For CNS-positive disease, treatment was intensified and contained methotrexate 8 g/m(2) and cytarabine 3 g/m(2). Fifty-nine patients (82%) achieved a remission. Thirteen of these relapsed, with a median time to relapse from the start of treatment of 5 months (range 3-14). Relapse included a new site in 9/13 patients. The probabilities of overall and event free survival at 5 years were 65% (53-76%) and 59% (47-70%), respectively, with a median follow up of 4.3 years. Mediastinal and visceral involvement at presentation were found to be predictive of an increased risk of failure.

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