Outcome of children with B cell lymphoma in Venezuela with the LMB‐89 protocol

Abstract

Background We analyzed the results of the LMB‐89 protocol performed in seven centers in Venezuela in 96 children having B‐cell non‐Hodgkin lymphoma treated from 1995 to 2002. Procedure Mean age was 7.1 years with 71 (74%) been male. Eighty‐two patients (85%) had diffuse small cell lymphoma Burkitt and Burkitt‐like, and 14 (15%) had diffuse large B‐cell lymphoma. Initial disease sites included the abdomen in 67%, peripheral nodes in 8%, and mediastinal in 4%. Treatment was directed to risk groups as described for LMB‐89 protocol. Group A: seven patients (7%), group B: 80 patients (83%), and group C: nine patients (9%). Results Mean follow‐up was 35 ± 31 months. Complete remission (CR) occurred in 70 patients (73%); four patients (6%) had relapse during the first year and ten patients (10%) had progressive disease. Overall survival (OS) and event free survival (EFS) were 85 and 80% at 1 year, and 82 and 75% at 2 years, respectively. The EFS by therapeutic groups at 3 years was A: 100%; B: 76%, and C: 56%. Toxicity: neutropenia in 75%, thrombocytopenia in 63%, febrile neutropenia in 39%. Viral infections: hepatitis B in 20%, hepatitis C in 2%, and Herpes zoster in 3%. Tumor lysis syndrome (TLS) occurred in 9% during induction phase with a high mortality of 44% (urate‐oxidase was available only at the end of the study). Conclusions The high mortality rate during induction phase prohibited a better EFS. Prophylactic use of xantine‐oxidase may improve future results. The high incidence of hepatitis B requires a vaccination program.