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

Area of Science:

• Pediatric Oncology
• Hematology
• Clinical Research

Background:

• Analysis of the LMB-89 protocol outcomes in 96 children with B-cell non-Hodgkin lymphoma treated in Venezuela between 1995 and 2002.
• The study population comprised children with a mean age of 7.1 years, predominantly male (74%).
• The majority of cases were diffuse small B-cell lymphoma (85%), with abdominal disease being the most common presentation (67%).

Purpose of the Study:

• To evaluate the efficacy and toxicity of the LMB-89 protocol in a Venezuelan pediatric cohort with B-cell non-Hodgkin lymphoma.
• To identify factors influencing treatment outcomes, including survival rates and toxicities.
• To provide recommendations for improving future treatment strategies and patient management.

Main Methods:

• Patients were stratified into risk groups (A, B, C) according to the LMB-89 protocol guidelines.
• Treatment protocols were adapted based on assigned risk groups.
• Data on complete remission, relapse, progressive disease, overall survival (OS), and event-free survival (EFS) were collected and analyzed.

Main Results:

• Complete remission (CR) was achieved in 73% of patients, with 1-year and 2-year overall survival rates of 85% and 82%, respectively.
• Event-free survival (EFS) at 3 years varied significantly by risk group: 100% for group A, 76% for group B, and 56% for group C.
• High rates of neutropenia (75%) and thrombocytopenia (63%) were observed. Tumor lysis syndrome (TLS) occurred in 9% during induction, with a 44% mortality rate.

Conclusions:

• High induction phase mortality negatively impacted event-free survival (EFS).
• Prophylactic administration of xanthine oxidase is suggested to potentially improve outcomes.
• The significant incidence of hepatitis B infection necessitates the implementation of a vaccination program for at-risk children.