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A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes

Publication ,  Journal Article
Gonzalez, CE; Shad, A; Adde, M; Mueller, BU; Venzon, DJ; Avila, N; Jaffe, ES; Kingma, D; Wood, LV; Pizzo, PA; Smithson, WA; Sleasman, JW; Magrath, I
Published in: International Journal of Pediatric Hematology/Oncology
October 4, 2001

Purpose. Obtain preliminary response, toxicity, and survival data in patients with non-Hodgkin's lymphomas (NHLs) and immunodeficiency syndromes using short-duration chemotherapy, granulocyte colony-stimulating factor (G-CSF), intravenous (IV) immunoglobulin, and for HIV-infected patients, antiretroviral therapy. Methods. The primary chemotherapy regimen consisted of three cycles of IV cyclophosphamide and methotrexate, and intrathecal (IT) cytarabine and methotrexate. A relapse regimen included IV ifosfamide, cytarabine, and IT methotrexate. Results. We treated 12 children with 13 NHLs. Nine (75%) achieved a complete response (CR), 2 (17%) had a partial response (PR), and 1 (8%) did not respond to the primary chemotherapy regimen. Patients who had a PR received the relapse regimen; one subsequently achieved CR and one did not respond. One (8%) patient relapsed 8 months after completion of the primary regimen. Overall median survival time was 28 months. Seven (58%) patients died, one due to progressive NHL and 6 as a consequence of their underlying illnesses. There was a significant difference in survival (p<0.01) between HIV-infected children with and without AIDS-defining conditions prior to the diagnosis of NHL. Only patients without AIDS-defining conditions at the time of diagnosis are currently alive. Grade 4 hematologic toxicity occurred in 8 (75%) and non-hematologic toxicity in 3 (25%) of the patients who received the primary regimen. Relapse chemotherapy was associated with a significantly higher incidence of toxicity. No opportunistic infections occurred during chemotherapy. Conclusions. Our treatment approach for NHL in immunocompromised children was well tolerated and effective. The treatment for lymphoma did not appear to modify the course of their underlying conditions.

Duke Scholars

Published In

International Journal of Pediatric Hematology/Oncology

ISSN

1070-2903

Publication Date

October 4, 2001

Volume

7

Issue

3

Start / End Page

167 / 187

Related Subject Headings

  • Pediatrics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gonzalez, C. E., Shad, A., Adde, M., Mueller, B. U., Venzon, D. J., Avila, N., … Magrath, I. (2001). A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes. International Journal of Pediatric Hematology/Oncology, 7(3), 167–187.
Gonzalez, C. E., A. Shad, M. Adde, B. U. Mueller, D. J. Venzon, N. Avila, E. S. Jaffe, et al. “A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes.” International Journal of Pediatric Hematology/Oncology 7, no. 3 (October 4, 2001): 167–87.
Gonzalez CE, Shad A, Adde M, Mueller BU, Venzon DJ, Avila N, et al. A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes. International Journal of Pediatric Hematology/Oncology. 2001 Oct 4;7(3):167–87.
Gonzalez, C. E., et al. “A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes.” International Journal of Pediatric Hematology/Oncology, vol. 7, no. 3, Oct. 2001, pp. 167–87.
Gonzalez CE, Shad A, Adde M, Mueller BU, Venzon DJ, Avila N, Jaffe ES, Kingma D, Wood LV, Pizzo PA, Smithson WA, Sleasman JW, Magrath I. A pilot study for the treatment of non-Hodgkin's lymphoma in children with acquired immunodeficiency syndromes. International Journal of Pediatric Hematology/Oncology. 2001 Oct 4;7(3):167–187.

Published In

International Journal of Pediatric Hematology/Oncology

ISSN

1070-2903

Publication Date

October 4, 2001

Volume

7

Issue

3

Start / End Page

167 / 187

Related Subject Headings

  • Pediatrics