Journal of Clinical Oncology, Vol 11, 1024-1032, Copyright © 1993 by American Society of Clinical Oncology
Long-term follow-up of patients treated with COMP or LSA2L2 therapy for childhood non-Hodgkin's lymphoma: a report of CCG-551 from the Childrens Cancer Group
JR Anderson, RD Jenkin, JF Wilson, CR Kjeldsberg, R Sposto, RR Chilcote, PF Coccia, PR Exelby, S Siegel and AT Meadows
University of Nebraska Medical Center, Omaha.
PURPOSE: We analyzed the long-term results of a Childrens Cancer Group
(CCG) randomized study comparing cyclophosphamide, vincristine,
methotrexate, and prednisone (COMP) versus LSA2L2 as treatment for
childhood non-Hodgkin's lymphoma. The initial results were previously
reported (N Engl J Med 308:559, 1983). PATIENTS AND METHODS: A total of 429
patients are reported here, 68 with localized disease and 361 with
disseminated disease. The distribution of disseminated-disease patients by
histologic type was 164 lymphoblastic, 60 large-cell, and 137
undifferentiated lymphomas. Median follow-up duration of surviving patients
is 8 years. RESULTS: Event-free survival (EFS) of patients with localized
disease was 84% at 5 years. No differences were seen between the two
treatment regimens. Results for patients with disseminated disease was
dependent on histologic subtype: patients with lymphoblastic lymphoma did
better when treated with LSA2L2 (5-year EFS of 64% v 35% for COMP); COMP
produced better results for patients with undifferentiated lymphoma (5-year
EFS of 50% v 29% for LSA2L2). Results for large-cell lymphoma patients were
similar (5-year EFS of 52% for COMP v 43% for LSA2L2). Five percent of
patients died of treatment- related complications while on therapy
(primarily infections). Only four deaths without progression have been
observed off-therapy (two from restrictive lung disease, one from an acute
asthma attack, one from colon cancer). Patient survival rates after
recurrence were poor. CONCLUSION: Treatment success can be expected in 84%
of pediatric patients with localized non-Hodgkin's lymphoma. For patients
with disseminated disease, treatment success can be expected in 64% of
those with lymphoblastic and 50% of those with undifferentiated or
large-cell disease. To date, late adverse events are rare.
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