ADULTS AND CHILDREN WITH SMALL NON-CLEAVED-CELL LYMPHOMA HAVE A SIMILAR EXCELLENT OUTCOME WHEN TREATED WITH THE SAME CHEMOTHERAPY REGIMEN

Purpose: We have used identical treatment protocols for adults and chi ldren with small non-cleaved-cell lymphoma (SNCL) for many years and r eport here the results of two successive treatment regimens in these a ge groups. Patients and Methods: Seventy-two patients (39 adults and 3 3 children) were treated with protocol 77-04 between 1977 and 1985. Al l patients, except those with resected abdominal disease, received 15 cycles of a combination of cyclophosphamide (CTX), doxorubicin (ADR), prednisone (PRED), vincristine (VCR), high-dose methotrexate (MTX), an d intrathecal (IT) therapy. Forty-one patients (20 adults and 21 child ren) were treated with protocol 89-C-41, which has been used since 198 9. High-risk patients received four alternating cycles (with a total d uration of 12 to 15 weeks) of an intensified version of protocol 77-04 without PRED (CODOX-M), and a new drug combination consisting of ifos famide, etoposide, high-dose cytarabine (ara-C), and IT MTX (IVAC). Lo w-risk patients received three cycles of the CODOX-M regimen, High-ris k patients were randomized to either receive or nor receive granulocyt e-macrophage colony-stimulating factor (GM-CSF). Results: Event-free s urvival (EFS) in protocol 77-04 wets 56% at 2 years and beyond, EFS in protocol 89-C-41 was 92% at 2 years and beyond, GM-CSF was associated with increased thrombocytopenia. Conclusion: Adults and children with SNCL have a similar Prognosis when treated with the same chemotherapy . EFS in high-risk patients has been markedly improved by including IV AC in protocol 89-C-41, and excellent results can be achieved with onl y four cycles of therapy. In protocol 89-C-41,GM-CSF was not beneficia l.