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

John T. Sandlund, Victor M. Santana, Melissa M. Hudson, Mihaela Onciu, David Head, Daryl J. Murry, Raul Ribeiro, Dana Wallace, Renee Rencher, Ching Hon Pui

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5 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)782-790
Number of pages9
JournalCancer
Volume113
Issue number4
DOIs
StatePublished - Aug 15 2008

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Keywords

  • Carboplatin
  • Childhood
  • Cytarabine
  • Dexamethasone
  • Large cell
  • Lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Sandlund, J. T., Santana, V. M., Hudson, M. M., Onciu, M., Head, D., Murry, D. J., Ribeiro, R., Wallace, D., Rencher, R., & Pui, C. H. (2008). Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood. Cancer, 113(4), 782-790. https://doi.org/10.1002/cncr.23630