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

Research output: Contribution to journalArticle

5 Citations (Scopus)

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

Fingerprint

Carboplatin
Cytarabine
Non-Hodgkin's Lymphoma
Dexamethasone
Vincristine
Doxorubicin
Cyclophosphamide
Survival Rate
Disease-Free Survival
Therapeutics
Prednisone
Confidence Intervals
Pediatrics

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood. / Sandlund, John T.; Santana, Victor M.; Hudson, Melissa M.; Onciu, Mihaela; Head, David; Murry, Daryl J; Ribeiro, Raul; Wallace, Dana; Rencher, Renee; Pui, Ching Hon.

In: Cancer, Vol. 113, No. 4, 15.08.2008, p. 782-790.

Research output: Contribution to journalArticle

Sandlund, JT, Santana, VM, Hudson, MM, Onciu, M, Head, D, Murry, DJ, Ribeiro, R, Wallace, D, Rencher, R & Pui, CH 2008, 'Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood', Cancer, vol. 113, no. 4, pp. 782-790. https://doi.org/10.1002/cncr.23630
Sandlund, John T. ; Santana, Victor M. ; Hudson, Melissa M. ; Onciu, Mihaela ; Head, David ; Murry, Daryl J ; Ribeiro, Raul ; Wallace, Dana ; Rencher, Renee ; Pui, Ching Hon. / Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood. In: Cancer. 2008 ; Vol. 113, No. 4. pp. 782-790.
@article{2c8da4999df3436bb4ead1ab346db7ac,
title = "Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood",
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.",
keywords = "Carboplatin, Childhood, Cytarabine, Dexamethasone, Large cell, Lymphoma",
author = "Sandlund, {John T.} and Santana, {Victor M.} and Hudson, {Melissa M.} and Mihaela Onciu and David Head and Murry, {Daryl J} and Raul Ribeiro and Dana Wallace and Renee Rencher and Pui, {Ching Hon}",
year = "2008",
month = "8",
day = "15",
doi = "10.1002/cncr.23630",
language = "English (US)",
volume = "113",
pages = "782--790",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood

AU - Sandlund, John T.

AU - Santana, Victor M.

AU - Hudson, Melissa M.

AU - Onciu, Mihaela

AU - Head, David

AU - Murry, Daryl J

AU - Ribeiro, Raul

AU - Wallace, Dana

AU - Rencher, Renee

AU - Pui, Ching Hon

PY - 2008/8/15

Y1 - 2008/8/15

N2 - 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.

AB - 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.

KW - Carboplatin

KW - Childhood

KW - Cytarabine

KW - Dexamethasone

KW - Large cell

KW - Lymphoma

UR - http://www.scopus.com/inward/record.url?scp=50249186466&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=50249186466&partnerID=8YFLogxK

U2 - 10.1002/cncr.23630

DO - 10.1002/cncr.23630

M3 - Article

VL - 113

SP - 782

EP - 790

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -