Improved outcome in childhood B-cell lymphoma with the intensified French LMB protocol

Background. During the last 20 years, 120 children with B cell lymphoma wer e treated at the National Pediatric Hematology/Oncology Center of Israel. U ntil 1986, 63 patients received an institutional protocol (BMC), and therea fter 57 patients received a modified French LMB protocol. We report the res ults of a retrospective analysis comparing the results of these two protoco ls. Procedure. Patient characteristics were similar in both groups except f or stage of disease and lactate dehydrogenase (LDH) levels. Significantly m ore patients in the LMB group had higher stage disease, and the LDH levels also were higher (<600 mu g/ml). Results. Fifty-four of fifty-seven childre n on the modified LMB protocol are alive, disease-free, with an overall eve nt-free survival of 94% (median follow-up of 73 months). Event-free surviva l for stages I, II, and III patients is 100%, and for stage IV 77%, whereas the overall event-free survival was 58% among 63 children treated previous ly, and for stage IV patients only 10%. Severe marrow suppression and neutr openic enterocolitis were the major complications of this intensive protoco l. Conclusions. Intensive chemotherapy with a modified LMB protocol and mod ern supportive care result in a high cure rate of childhood B cell lymphoma even in patients with advanced disease. (C) 2000 Wiley-Liss, Inc.