Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children
Early-stage non-Hodgkin’s lymphomas (ES-NHL) are associated with high survival rates. To minimize the risk of long-term sequelae, the duration and intensity of chemotherapy have been progressively reduced. Between 1988 and 2018, children with ES-NHL were treated at a single institute with two subseq...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/9/1279 |
| _version_ | 1797489928610775040 |
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| author | Elisabetta Schiavello Filippo Spreafico Francesco Barretta Giulia Meraviglia Veronica Biassoni Monica Terenziani Luna Boschetti Giovanna Gattuso Stefano Chiaravalli Luca Bergamaschi Nadia Puma Giovanna Sironi Olga Nigro Marta Podda Cristina Meazza Michela Casanova Andrea Ferrari Roberto Luksch Maura Massimino |
| author_facet | Elisabetta Schiavello Filippo Spreafico Francesco Barretta Giulia Meraviglia Veronica Biassoni Monica Terenziani Luna Boschetti Giovanna Gattuso Stefano Chiaravalli Luca Bergamaschi Nadia Puma Giovanna Sironi Olga Nigro Marta Podda Cristina Meazza Michela Casanova Andrea Ferrari Roberto Luksch Maura Massimino |
| author_sort | Elisabetta Schiavello |
| collection | DOAJ |
| description | Early-stage non-Hodgkin’s lymphomas (ES-NHL) are associated with high survival rates. To minimize the risk of long-term sequelae, the duration and intensity of chemotherapy have been progressively reduced. Between 1988 and 2018, children with ES-NHL were treated at a single institute with two subsequent protocols. Protocol I consisted of a 7-week induction phase followed by a maintenance phase alternating 6-mercaptopurine plus MTX, a brief reinduction, and thioguanine plus cytosine arabinoside, for a total duration of 8 months. The subsequent protocol II (applied since 1997) was modified adding etoposide plus a further dose of HD-MTX and omitting maintenance in all histological subtypes except T-lymphoblastic lymphoma (T-LBL), for a total duration of 9 weeks. Intrathecal prophylaxis was not provided in either protocol. With a median follow-up of 98.4 months, the 5-year event-free survival (EFS) rates in protocol I (<i>n</i> = 21) and II (<i>n</i> = 25) were 76.2% and 96%, respectively, and the 5-year overall survival (OS) rates were 90.5% and 96%, respectively. None of the patients experienced disease progression or relapse within the central nervous system (CNS). Acute toxicity was manageable in both protocols, except for a case of presumed acute cardiotoxic death; no chronic sequelae were evident. Low-intensity chemotherapy for 9 weeks without intrathecal prophylaxis was sufficient for curing children with ES-NHL, without jeopardizing the excellent survival rate of this disease. |
| first_indexed | 2024-03-10T00:24:39Z |
| format | Article |
| id | doaj.art-4b983c4949c84ac299e57821216db42c |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T00:24:39Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-4b983c4949c84ac299e57821216db42c2023-11-23T15:36:18ZengMDPI AGChildren2227-90672022-08-0199127910.3390/children9091279Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in ChildrenElisabetta Schiavello0Filippo Spreafico1Francesco Barretta2Giulia Meraviglia3Veronica Biassoni4Monica Terenziani5Luna Boschetti6Giovanna Gattuso7Stefano Chiaravalli8Luca Bergamaschi9Nadia Puma10Giovanna Sironi11Olga Nigro12Marta Podda13Cristina Meazza14Michela Casanova15Andrea Ferrari16Roberto Luksch17Maura Massimino18Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyDepartment of Clinical Epidemiology and Trial Organisation, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyDepartment of Pediatrics, Vittore Buzzi Hospital, University of Milan, 20122 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyPediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, ItalyEarly-stage non-Hodgkin’s lymphomas (ES-NHL) are associated with high survival rates. To minimize the risk of long-term sequelae, the duration and intensity of chemotherapy have been progressively reduced. Between 1988 and 2018, children with ES-NHL were treated at a single institute with two subsequent protocols. Protocol I consisted of a 7-week induction phase followed by a maintenance phase alternating 6-mercaptopurine plus MTX, a brief reinduction, and thioguanine plus cytosine arabinoside, for a total duration of 8 months. The subsequent protocol II (applied since 1997) was modified adding etoposide plus a further dose of HD-MTX and omitting maintenance in all histological subtypes except T-lymphoblastic lymphoma (T-LBL), for a total duration of 9 weeks. Intrathecal prophylaxis was not provided in either protocol. With a median follow-up of 98.4 months, the 5-year event-free survival (EFS) rates in protocol I (<i>n</i> = 21) and II (<i>n</i> = 25) were 76.2% and 96%, respectively, and the 5-year overall survival (OS) rates were 90.5% and 96%, respectively. None of the patients experienced disease progression or relapse within the central nervous system (CNS). Acute toxicity was manageable in both protocols, except for a case of presumed acute cardiotoxic death; no chronic sequelae were evident. Low-intensity chemotherapy for 9 weeks without intrathecal prophylaxis was sufficient for curing children with ES-NHL, without jeopardizing the excellent survival rate of this disease.https://www.mdpi.com/2227-9067/9/9/1279non-Hodgkin lymphomaearly-stagechemotherapylate-effectsintrathecalmaintenance |
| spellingShingle | Elisabetta Schiavello Filippo Spreafico Francesco Barretta Giulia Meraviglia Veronica Biassoni Monica Terenziani Luna Boschetti Giovanna Gattuso Stefano Chiaravalli Luca Bergamaschi Nadia Puma Giovanna Sironi Olga Nigro Marta Podda Cristina Meazza Michela Casanova Andrea Ferrari Roberto Luksch Maura Massimino Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children Children non-Hodgkin lymphoma early-stage chemotherapy late-effects intrathecal maintenance |
| title | Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children |
| title_full | Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children |
| title_fullStr | Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children |
| title_full_unstemmed | Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children |
| title_short | Ultra Short Course Chemotherapy for Early-Stage Non-Hodgkin’s Lymphoma in Children |
| title_sort | ultra short course chemotherapy for early stage non hodgkin s lymphoma in children |
| topic | non-Hodgkin lymphoma early-stage chemotherapy late-effects intrathecal maintenance |
| url | https://www.mdpi.com/2227-9067/9/9/1279 |
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