       Document 0232
 DOCN  M9550232
 TI    Small noncleaved cell lymphoma and leukemia in adults. A retrospective
       study of 65 adults treated with the LMB pediatric protocols.
 DT    9505
 AU    Soussain C; Patte C; Ostronoff M; Delmer A; Rigal-Huguet F; Cambier N;
       Leprise PY; Francois S; Cony-Makhoul P; Harousseau JL; et al; Institut
       Gustave Roussy, Villejuif, France.
 SO    Blood. 1995 Feb 1;85(3):664-74. Unique Identifier : AIDSLINE
       MED/95134897
 AB    In France, more than 80% of children with Burkitt's lymphoma or
       Burkitt's leukemia (ALL3) are now cured with the LMB (B-cell
       non-Hodgkin's lymphoma and B-ALL) protocols of the Societe Francaise
       d'Oncologie Pediatrique, but so far, poor results have been obtained in
       the few adult studies available. We have analyzed the experience with
       LMB protocols in adult patients. This retrospective study involved 65
       adult patients with small noncleaved cell lymphoma or ALL3 treated with
       the LMB protocols. They were 17 to 65 years old and not previously
       treated. Human immunodeficiency virus-infected patients were excluded.
       The diagnoses were made between September 1984 and August 1991.
       According to the Murphy classification, 12 patients (18%) had stage I or
       II disease, 25 (38%), stage III disease; 4 (6%), stage IV disease; and
       24 (37%), ALL3 (> or = 25% blasts). According to the Ann Arbor
       classification, 9 patients had stage I disease; 8 patients, stage II; 5
       patients, stage III; 21 patients, stage IV disease; and 22 patients, ALL
       (> or = 30% blasts). Twelve patients had central nervous system (CNS)
       involvement before treatment. Thirty-nine patients were treated
       according to the LMB 84 protocol scheme; 14 according to the LMB 86
       protocol, and 12 patients received the LMB 84 induction courses followed
       by the LMB 86 consolidation courses. Three patients underwent bone
       marrow transplantation (BMT) while in second complete remission (CR) and
       3 others had refractory disease. There were some protocol violations
       caused by empirical medical decisions: local irradiation was performed
       in 4 patients, 2 patients received prophylactic radiation to the brain
       that was not specified in the protocol, 13 patients underwent BMT in
       first CR, and methotrexate doses were modified in 10 patients.
       Fifty-eight patients (89%) achieved a CR. There were four (6%) primary
       induction treatment failures, and three (4%) early treatment-related
       deaths. Eight patients relapsed between 2 and 30 months after CR
       (median, 4.7 months). Forty-seven patients are alive in CR (45 first CR,
       2 second CR) with a median follow-up of 57 months (24 to 93 months).
       There were five toxicity-related deaths among patients in CR including
       four BMT-related deaths and five deaths caused by refractory relapses.
       One patient died in CR at 62 months of rectal cancer. The 3-year overall
       survival rate is 74% (SE = 5). According to the stages in the Murphy
       classification, the 3-year survival rates are stages I and II, 100%;
       stage III, 80% (SE = 7); and stage IV and ALL, 57% (SE = 8). Seven of 12
       patients with initial CNS disease are alive with a median survival of 56
       months.(ABSTRACT TRUNCATED AT 400 WORDS)
 DE    Adolescence  Aged  Antineoplastic Agents, Combined/*THERAPEUTIC USE
       Bone Marrow Transplantation  Child  Cyclophosphamide/ADMINISTRATION &
       DOSAGE  Cytarabine/ADMINISTRATION & DOSAGE  Female  Human  Leukemia,
       Lymphocytic, Acute/*DRUG THERAPY/MORTALITY/PATHOLOGY/  THERAPY
       Lymphoma, Small Noncleaved-Cell/*DRUG THERAPY/MORTALITY/PATHOLOGY/
       THERAPY  Male  Methotrexate/ADMINISTRATION & DOSAGE  Middle Age
       Neoplasm Staging  Pregnancy  Prognosis  Retrospective Studies  Survival
       Rate  Treatment Outcome  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

