Childhood Non-Hodgkin's Lymphoma

TLDR

A randomized trial by the Children’s Cancer Study Group compared a 4‑drug COMP regimen with a 10‑drug modified LSA2‑L2 regimen in 234 eligible childhood and adolescent non‑Hodgkin lymphoma patients. Overall 24‑month failure‑free survival was 60 %, and the 10‑drug program achieved higher survival in disseminated lymphoblastic disease (76 % vs. 26 %, P = 0.0002), whereas the 4‑drug program was superior in non‑lymphoblastic disease (57 % vs.

Abstract

Members of the Childrens Cancer Study Group treated 234 eligible patients in a randomized trial designed to study the relative effectiveness of two therapy programs for the treatment of childhood and adolescent non-Hodgkin's lymphoma. Two chemotherapeutic strategies were compared: a 4-drug regimen (COMP) and a 10-drug regimen (modified LSA2-L2). Failure-free survival for all patients was 60 per cent at 24 months. In patients with disseminated disease treatment success was influenced by both the histologic subtype of disease and the therapeutic regimen followed. The 10-drug program was more effective than the 4-drug program in patients with disseminated lymphoblastic disease (two-year failure-free survival rate, 76 vs. 26 per cent, respectively; P = 0.0002), whereas the 4-drug program was more effective than the 10-drug program in those with nonlymphoblastic disease (57 vs. 28 per cent, respectively, P = 0.008). The less toxic, more easily administered 4-drug regimen was as effective as the 10-drug regimen in patients with localized disease (89 vs. 84 per cent, respectively). (N Engl J Med. 1983; 308:559–65.)