[Comparison of the efficacy of CCCG-97 and BFM-90 protocols in the treatment for children with mature B-cell non-Hodgkin's lymphoma].

Objective The aim of this study was to evaluate the efficacy and toxicity of the CCCG- 97 and BFM-90 protocols in the treatment of pediatric patients with B-cell non-Hodgkin＇ s lymphoma （ B- NHL） retrospectively, and to explore the optimal therapeutic strategy. Methods Forty-five consecutive untreated patients （age of 18 years or less） with newly diagnosed B-NHL （including Burkitt Lymphoma and diffuse large B-cell lymphoma）, treated in our hospital between July 1999 and December 2008 were enrolled in this study. The patients were classified into 2 groups by different protocols. From July 1999 to December 2004, twenty-one 3- to 13.8-year-old children were enrolled in the CCCG-97 group, with 1 in stage I / Ⅱ, and 20 in stage m/IV （ st Jude staging）. From January 2005 to December 2008, twenty-four 2.8- to 14.1- year-old cases were enrolled in the BFM-90 group, with 3 in stage I/II, and 21 in stage Ⅲ/IV （St Jude staging）. The survival rates were evaluated by Kaplan-Meier analysis. Results Forty of the 45 patients （88.9%） reached complete response （CR） after 2 courses of chemotherapy. In the CCCG-97 group, the CR rate was 95.2% （20/21 pts）, while that in the BFM-90 group was 83.3% （20/24 pts）. At a median follow-up time of 62 （17 to 131 ） months, the 5-year event-free survival （EFS） was 71.8% for all patients,and 69.1% for Stage Ill~IV, respectively. In the CCCG-97 group, the 3-year EFS was 76.2%. In the BFM-90 group, it was 75.0%. There was no significant difference in survival rates between the CCCG-97 and BFM-90 groups （ P = 0.975 ）. Unfavorable events recorded were as follows ： Death of progression before achieving CR during induction therapy in 4 cases, and relapse after achieving CR in 6 cases. The relapse rates were 19.0% （4/21 pts） in the CCCG-97 group and 8.3% （2/24 pts） in the BFM-90 group, with a non-significant statistical difference （ P = 0. 292 ）. Major toxicities were myelosuppression and mucositis, especially in the BFM-90 group, but were tolerable and manageable, five patients in the BFM-90 group received rituximab, 2 patients （Stage III ） achieved CR, while the other 3 patients （Stage IV ） had progressive disease or relapse. Conclusions Short-pulse and intensive chemotherapy, stratified according to stage of disease, can improve the survival rate of pediatric mature B-NHL. The efficacy of the CCCG-97 protocol and BFM-90 protocol is comparable and the toxicity is tolerable. Key words: Lymphoma, non-Hodgkin＇s ;  Children ;  Treatment outcome;  Prognosis