Difference between revisions of "Non-Hodgkin lymphoma, pediatric"
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+ | =Guidelines= | ||
+ | ==[https://www.nccn.org/ NCCN]== | ||
+ | *[https://www.nccn.org/professionals/physician_gls/pdf/ped_b-cell.pdf NCCN Guidelines - Pediatric Aggressive Mature B-Cell Lymphomas] | ||
=Untreated, pre-phase= | =Untreated, pre-phase= | ||
==CVP {{#subobject:1a817a|Regimen=1}}== | ==CVP {{#subobject:1a817a|Regimen=1}}== |
Revision as of 19:44, 5 September 2023
Section editor | |
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David Noyd, MD, MPH University of Washington Seattle, WA, USA |
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
|
Guidelines
NCCN
Untreated, pre-phase
CVP
CVP: Cyclophosphamide, Vincristine, Prednisone
COP: Cyclophosphamide, Oncovin (Vincristine), Prednisone
Regimen
Study | Dates of enrollment | Evidence |
---|---|---|
Patte et al. 2007 (FAB/LMB96) | 1996-2001 | Non-randomized part 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
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Patte et al. 2007 (FAB/LMB96) | 1996-2001 | Non-randomized part 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
Regimen
Study | Dates 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 (secondary endpoint) 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