Difference between revisions of "Non-Hodgkin lymphoma, pediatric"

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m (Text replacement - "====CNS prophylaxis" to "====CNS therapy, prophylaxis")
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{{TOC limit|limit=3}}
 
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=Untreated, pre-phase=
 
=Untreated, pre-phase=
 
==CVP {{#subobject:1a817a|Regimen=1}}==
 
==CVP {{#subobject:1a817a|Regimen=1}}==
−
 
 
CVP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisone
 
CVP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisone
 
<br>COP: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
<br>COP: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 +
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:865d9b|Variant=1}}===
 
===Regimen {{#subobject:865d9b|Variant=1}}===
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 60%; text-align:center;"  
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|-
 
|-
 
|}
 
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Cyclophosphamide (Cytoxan)]] 300 mg/m<sup>2</sup> IV once on day 1
 
*[[Cyclophosphamide (Cytoxan)]] 300 mg/m<sup>2</sup> IV once on day 1
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====Glucocorticoid therapy====
 
====Glucocorticoid therapy====
 
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup>/day IV or PO on days 1 to 7
 
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup>/day IV or PO on days 1 to 7
−
 
 
====CNS therapy, prophylaxis====
 
====CNS therapy, prophylaxis====
 
*[[Methotrexate (MTX)]] (dose not specified) IT once on day 1
 
*[[Methotrexate (MTX)]] (dose not specified) IT once on day 1
−
 
 
'''7-day course'''
 
'''7-day course'''
 +
</div>
 +
<div class="toccolours" style="background-color:#cbd5e7">
 
====Subsequent treatment====
 
====Subsequent treatment====
 
*[[#COPADM|COPADM]] induction
 
*[[#COPADM|COPADM]] induction
−
 
+
</div></div>
 
===References===
 
===References===
 
# '''FAB/LMB96:''' Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. [https://doi.org/10.1182/blood-2006-07-036673 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc1852229/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132719/ PubMed] NCT00002757
 
# '''FAB/LMB96:''' Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. [https://doi.org/10.1182/blood-2006-07-036673 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc1852229/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132719/ PubMed] NCT00002757
−
 
 
=Untreated, induction=
 
=Untreated, induction=
 
==COPADM {{#subobject:841673|Regimen=1}}==
 
==COPADM {{#subobject:841673|Regimen=1}}==
−
 
 
COPADM: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>AD</u>'''riamycin (Doxorubicin), '''<u>M</u>'''ethotrexate
 
COPADM: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>AD</u>'''riamycin (Doxorubicin), '''<u>M</u>'''ethotrexate
 +
<div class="toccolours" style="background-color:#eeeeee">
 
===Protocol {{#subobject:39dc15|Variant=1}}===
 
===Protocol {{#subobject:39dc15|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
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|}
 
|}
 
''Note: It is not clear from Patte et al. 2007 whether the cyclophosphamide was fractionated.''
 
''Note: It is not clear from Patte et al. 2007 whether the cyclophosphamide was fractionated.''
 +
<div class="toccolours" style="background-color:#cbd5e8">
 
====Preceding treatment====
 
====Preceding treatment====
 
*[[#CVP|COP]] pre-phase
 
*[[#CVP|COP]] pre-phase
 +
</div>
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Cyclophosphamide (Cytoxan)]] 250 mg/m<sup>2</sup> IV twice per day on days 2 to 4 (total dose: 1500 mg/m<sup>2</sup>)
 
*[[Cyclophosphamide (Cytoxan)]] 250 mg/m<sup>2</sup> IV twice per day on days 2 to 4 (total dose: 1500 mg/m<sup>2</sup>)
Line 81: Line 83:
 
====Supportive therapy====
 
====Supportive therapy====
 
*[[Folinic acid (Leucovorin)]]
 
*[[Folinic acid (Leucovorin)]]
−
 
 
====CNS therapy, prophylaxis====
 
====CNS therapy, prophylaxis====
 
*[[Methotrexate (MTX)]] (dose not specified) IT once per day on days 2 & 6
 
*[[Methotrexate (MTX)]] (dose not specified) IT once per day on days 2 & 6
−
 
 
'''One course'''
 
'''One course'''
−
 
+
</div>
 +
<div class="toccolours" style="background-color:#cbd5e7">
 
====Subsequent treatment====
 
====Subsequent treatment====
 
*[[#COPADM|COPADM]] re-induction; reduced-dose versus [[#COPADM|COPADM]] re-induction; standard-dose
 
*[[#COPADM|COPADM]] re-induction; reduced-dose versus [[#COPADM|COPADM]] re-induction; standard-dose
−
 
+
</div></div>
 
===References===
 
===References===
 
# '''FAB/LMB96:''' Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. [https://doi.org/10.1182/blood-2006-07-036673 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc1852229/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132719/ PubMed] NCT00002757
 
# '''FAB/LMB96:''' Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. [https://doi.org/10.1182/blood-2006-07-036673 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc1852229/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132719/ PubMed] NCT00002757
 
# '''Inter-B-NHL Ritux 2010:''' Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. [https://doi.org/10.1056/nejmoa1915315 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7720281/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/32492302/ PubMed] NCT01516580
 
# '''Inter-B-NHL Ritux 2010:''' Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. [https://doi.org/10.1056/nejmoa1915315 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7720281/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/32492302/ PubMed] NCT01516580
−
 
 
==R-COPADM {{#subobject:bac173|Regimen=1}}==
 
==R-COPADM {{#subobject:bac173|Regimen=1}}==
−
 
 
R-COPADM: '''<u>R</u>'''ituximab, '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>AD</u>'''riamycin (Doxorubicin), '''<u>M</u>'''ethotrexate
 
R-COPADM: '''<u>R</u>'''ituximab, '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>AD</u>'''riamycin (Doxorubicin), '''<u>M</u>'''ethotrexate
 +
<div class="toccolours" style="background-color:#eeeeee">
 
===Protocol {{#subobject:avdc15|Variant=1}}===
 
===Protocol {{#subobject:avdc15|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
Line 113: Line 113:
 
|}
 
|}
 
''Note: Only partial dosing information is available in the manuscript/supplement; dosing here is primarily based on FAB/LMB96.''
 
''Note: Only partial dosing information is available in the manuscript/supplement; dosing here is primarily based on FAB/LMB96.''
 +
<div class="toccolours" style="background-color:#cbd5e8">
 
====Preceding treatment====
 
====Preceding treatment====
 
*[[#CVP|COP]] pre-phase
 
*[[#CVP|COP]] pre-phase
 +
</div>
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Targeted therapy====
 
====Targeted therapy====
 
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once per day on days -2 & 1
 
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once per day on days -2 & 1
Line 126: Line 129:
 
====Supportive therapy====
 
====Supportive therapy====
 
*[[Folinic acid (Leucovorin)]]
 
*[[Folinic acid (Leucovorin)]]
−
 
 
====CNS therapy, prophylaxis====
 
====CNS therapy, prophylaxis====
 
*[[Methotrexate (MTX)]] (dose not specified) IT once per day on days 2 & 6
 
*[[Methotrexate (MTX)]] (dose not specified) IT once per day on days 2 & 6
−
 
 
'''One course'''
 
'''One course'''
−
 
+
</div>
 +
<div class="toccolours" style="background-color:#cbd5e7">
 
====Subsequent treatment====
 
====Subsequent treatment====
 
*[[#R-COPADM|R-COPADM]] re-induction
 
*[[#R-COPADM|R-COPADM]] re-induction
−
 
+
</div></div>
 
===References===
 
===References===
 
# '''Inter-B-NHL Ritux 2010:''' Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. [https://doi.org/10.1056/nejmoa1915315 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7720281/ link to PMC article] '''contains partial protocol''' [https://pubmed.ncbi.nlm.nih.gov/32492302/ PubMed] NCT01516580
 
# '''Inter-B-NHL Ritux 2010:''' Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. [https://doi.org/10.1056/nejmoa1915315 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7720281/ link to PMC article] '''contains partial protocol''' [https://pubmed.ncbi.nlm.nih.gov/32492302/ PubMed] NCT01516580
−
 
 
[[Category:Non-Hodgkin lymphoma regimens]]
 
[[Category:Non-Hodgkin lymphoma regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
 
[[Category:Lymphomas]]
 
[[Category:Lymphomas]]
 
[[Category:Pediatric hematologic neoplasms]]
 
[[Category:Pediatric hematologic neoplasms]]

Revision as of 00:13, 1 March 2023

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Section editor transclusions This page contains studies that were specific to pediatric populations, who are generally treated based on risk-stratification, not on the underlying histology. See individual trials for inclusion criteria.

3 regimens on this page
3 variants on this page


Untreated, pre-phase

CVP

CVP: Cyclophosphamide, Vincristine, Prednisone
COP: Cyclophosphamide, Oncovin (Vincristine), Prednisone

Regimen

Study Years of enrollment Evidence
Patte et al. 2007 (FAB/LMB96) 1996-2001 Non-randomized portion of phase 3 RCT

Chemotherapy

Glucocorticoid therapy

CNS therapy, prophylaxis

7-day course

Subsequent treatment

References

  1. FAB/LMB96: Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00002757

Untreated, induction

COPADM

COPADM: Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin), Methotrexate

Protocol

Study Years of enrollment Evidence Comparator Comparative Efficacy
Patte et al. 2007 (FAB/LMB96) 1996-2001 Non-randomized portion of phase 3 RCT
Minard-Colin et al. 2020 (Inter-B-NHL Ritux 2010) 2011-2015 Phase 3 (C) R-COPADM Inferior OS

Note: It is not clear from Patte et al. 2007 whether the cyclophosphamide was fractionated.

Preceding treatment

Chemotherapy

Glucocorticoid therapy

Supportive therapy

CNS therapy, prophylaxis

One course

Subsequent treatment

  • COPADM re-induction; reduced-dose versus COPADM re-induction; standard-dose

References

  1. FAB/LMB96: Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS; FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007 Apr 1;109(7):2773-80. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00002757
  2. Inter-B-NHL Ritux 2010: Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. link to original article link to PMC article PubMed NCT01516580

R-COPADM

R-COPADM: Rituximab, Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin), Methotrexate

Protocol

Study Years of enrollment Evidence Comparator Comparative Efficacy
Minard-Colin et al. 2020 (Inter-B-NHL Ritux 2010) 2011-2015 Phase 3 (E-RT-esc) COPADM Superior OS
OS36: 95.1% vs 87.3%
(HR 0.36, 95% CI 0.16-0.82)

Note: Only partial dosing information is available in the manuscript/supplement; dosing here is primarily based on FAB/LMB96.

Preceding treatment

Targeted therapy

Chemotherapy

Glucocorticoid therapy

Supportive therapy

CNS therapy, prophylaxis

One course

Subsequent treatment

References

  1. Inter-B-NHL Ritux 2010: Minard-Colin V, Aupérin A, Pillon M, Burke GAA, Barkauskas DA, Wheatley K, Delgado RF, Alexander S, Uyttebroeck A, Bollard CM, Zsiros J, Csoka M, Kazanowska B, Chiang AK, Miles RR, Wotherspoon A, Adamson PC, Vassal G, Patte C, Gross TG; European Intergroup for Childhood Non-Hodgkin Lymphoma; Children’s Oncology Group. Rituximab for High-Risk, Mature B-Cell Non-Hodgkin's Lymphoma in Children. N Engl J Med. 2020 Jun 4;382(23):2207-2219. link to original article link to PMC article contains partial protocol PubMed NCT01516580
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