Difference between revisions of "Non-Hodgkin lymphoma, pediatric"
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=Untreated, pre-phase= | =Untreated, pre-phase= | ||
==CVP {{#subobject:1a817a|Regimen=1}}== | ==CVP {{#subobject:1a817a|Regimen=1}}== | ||
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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
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
- Cyclophosphamide (Cytoxan) 300 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1 mg/m2 IV once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2/day IV or PO on days 1 to 7
CNS therapy, prophylaxis
- Methotrexate (MTX) (dose not specified) IT once on day 1
7-day course
Subsequent treatment
- COPADM induction
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. 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
- COP pre-phase
Chemotherapy
- Cyclophosphamide (Cytoxan) 250 mg/m2 IV twice per day on days 2 to 4 (total dose: 1500 mg/m2)
- Vincristine (Oncovin) 2 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2/day IV or PO on days 1 to 7
Supportive therapy
CNS therapy, prophylaxis
- Methotrexate (MTX) (dose not specified) IT once per day on days 2 & 6
One course
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. link to original article link to PMC article contains dosing details in manuscript 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. 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
- COP pre-phase
Targeted therapy
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days -2 & 1
Chemotherapy
- Cyclophosphamide (Cytoxan) 250 mg/m2 IV twice per day on days 2 to 4 (total dose: 1500 mg/m2)
- Vincristine (Oncovin) 2 mg/m2 IV once on day 1
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Glucocorticoid therapy
- Prednisone (Sterapred) 60 mg/m2/day IV or PO on days 1 to 7
Supportive therapy
CNS therapy, prophylaxis
- Methotrexate (MTX) (dose not specified) IT once per day on days 2 & 6
One course
Subsequent treatment
- R-COPADM re-induction
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. link to original article link to PMC article contains partial protocol PubMed NCT01516580