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Clinical Trial
. 2008 Aug 15;113(4):782-90.
doi: 10.1002/cncr.23630.

Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood

John T Sandlund  1 , Victor M Santana, Melissa M Hudson, Mihaela Onciu, David Head, Daryl J Murry, Raul Ribeiro, Dana Wallace, Renee Rencher, Ching-Hon Pui
Affiliations
Clinical Trial

Combination of dexamethasone, high-dose cytarabine, and carboplatin is effective for advanced large-cell non-Hodgkin lymphoma of childhood

John T Sandlund et al. Cancer. .

Abstract

Background: The purpose of the current study was to evaluate the activity and toxicity of dexamethasone, high-dose cytarabine, and carboplatin (DAC) combination therapy in children with newly diagnosed large-cell non-Hodgkin lymphoma (NHL) and to estimate the event-free and overall survival rates achieved when DAC is incorporated into a conventional regimen.

Methods: From 1991 to 1997, 20 boys and 5 girls aged 4.2 to 17.7 years who had stage III (according to the St. Jude staging system) (n = 21) or stage IV (n = 4) large-cell NHL were treated in this study. DAC therapy was administered at the beginning of the induction phase in 2 sequential cycles and incorporated throughout a continuation phase (modified from the ACOP+ regimen, which features doxorubicin, cyclophosphamide, vincristine, and prednisone) with doxorubicin, cyclophosphamide, vincristine, and dexamethasone. The total duration of treatment was approximately 10 months.

Results: DAC therapy yielded a response in 22 of 25 patients (88%; 95% confidence interval [95% CI], 68%-97%): complete remission in 13 cases (52%), and partial response in 9 (36%). After additional treatment with doxorubicin, cyclophosphamide, vincristine, and dexamethasone, complete remission was attained in 18 patients (72%) and partial remission in 3 (12%). The event-free survival rate (+/- the standard error [SE]) was 64% +/- 9% and the overall survival rate was 80% +/- 8% at 5 years.

Conclusions: The results of the current study indicate that the DAC regimen is well tolerated and effective for pediatric patients with large-cell NHL.

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Figures

Figure 1
Figure 1
Treatment scheme for the DAC regimen. Treatment was given over a 10-month period. If there was no response to DAC during induction therapy, the patient was taken off the study.*
Figure 2
Figure 2
Event-free survival and overall survival for 25 children treated with the DAC regimen. The triangles denote patients still at risk for adverse events.
See this image and copyright information in PMC

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