Journal of Clinical Oncology, Vol 2, 88-97, Copyright © 1984 by American Society of Clinical Oncology
The treatment of localized non-Hodgkin's lymphoma in children: a report from the Children's Cancer Study Group
RD Jenkin, JR Anderson, RR Chilcote, PF Coccia, PR Exelby, JH Kersey, JH Kushner, AT Meadows, SE Siegel and R Sposto
Investigators of the Children's Cancer Study Group entered 73 children with
previously untreated localized non-Hodgkin's lymphoma on a prospective
randomized trial of systemic treatment with either a four- drug program
(cyclophosphamide, vincristine, methotrexate, prednisone [COMP]) or a
10-drug (LSA2-L2 modified) program of 18 months duration. All patients
received central nervous system prophylaxis with intrathecal methotrexate
and most received local or regional radiation treatment. The three-year
relapse-free survival rate for all patients (N = 73) was 84%; for COMP (N =
42) was 85%, and for LSA2-L2 (N = 31) was 84%. Of the 12 patients who
suffered adverse events eight relapsed and four died of toxicity.
Histopathology was reviewed centrally. Of 32 patients with nonlymphoblastic
disease treated with COMP only one relapsed. Of 26 patients treated with
LSA2-L2, four relapsed. Patients with localized lymphoblastic disease were
uncommon. None of three patients treated with LSA2-L2 relapsed compared
with three of nine treated with COMP. COMP is an excellent treatment for
patients with localized disease of nonlymphoblastic type, but the relative
value of the two regimens for patients with localized lymphoblastic disease
is uncertain.
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