Favorable outcomes and reduced toxicity with a novel vinblastine-based non-high dose methotrexate (HDMTX) regimen (modified MCP-842) in pediatric anaplastic large cell lymphoma (ALCL): experience from India
| Autor: | Sumeet Gujral, Maya Prasad, Shripad Banavali, Seema Kembhavi, Nirmalya Pradhan, Gaurav Narula, Tanuja Shet, Sneha Shah, Epari Sridhar, Deepa S Joy Phillip, Kalasekhar Vijayasekharan |
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| Rok vydání: | 2019 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty India Vinblastine 03 medical and health sciences 0302 clinical medicine immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Child Anaplastic large-cell lymphoma business.industry Hematology medicine.disease High dose methotrexate Lymphoma Pediatric Anaplastic Large Cell Lymphoma Regimen Methotrexate Reduced toxicity 030220 oncology & carcinogenesis Lymphoma Large-Cell Anaplastic business 030215 immunology medicine.drug |
| Zdroj: | Leukemia & Lymphoma. 61:912-918 |
| ISSN: | 1029-2403 1042-8194 |
| Popis: | Anaplastic large cell lymphoma (ALCL) is a rare form of non-Hodgkin lymphoma (NHL) in children. Most treatment regimens include high-dose methotrexate (HDMTX), which is logistically difficult to administer in resource-limited settings. We evaluated the outcomes of pediatric ALCL patients treated on a uniform protocol (Modified Multicentric Protocol, MCP-842 regimen) at our hospital between January 2005 and December 2016. Of the 68 patients who received treatment on the Modified MCP842 protocol, 46 patients are alive in remission, 11(16%) had disease progression, 9(13%) relapsed after achieving remission, and 5(7%) had treatment-related mortality (TRM). Seventeen of 20 relapsed/progressed patients subsequently expired. With a median follow-up of 55 months (range 2-165 months), the 4-year event-free survival (EFS) and overall survival (OS) are 63% (95% CI of 50-73%) and 70%(95% CI of 57-79%), respectively. An indigenous protocol using vinblastine (without HDMTX and steroids) is feasible in a resource-limited setting and achieves outcomes comparable to regimens incorporating HDMTX, with lower toxicity. |
| Databáze: | OpenAIRE |
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