A new treatment protocol for childhood non-Hodgkin's lymphoma: preliminary evaluation

Between November 1986 and July 1988, 21 consecutively diagnosed children with nonlocalized abdominal lymphoma (Murphy's stage III and IV without CNS disease) were eligible for treatment with a multidrug chemotherapy schedule. The induction phase was the same for all (fractionated cyclophosphamide, intermedian-dose methotrexate [Mtx], vincristine [Vcr], and prednisone). After that the children were randomized to repeat the same scheme or intercalate teniposide (VM26) plus cytarabine (AraC) with the induction-phase scheme. All of them were treated for only 6 months. The protocol approved to be very effective with 85% remission in all the children and 94% survival in patients surviving the induction phase. The toxicity was acceptable, also considering the characteristics of our population (malnourished children). The group VM26 and AraC had few hospital admissions in spite of the small number of children because they received VM26 and AraC as outpatients. The sale purpose of the present study is to report that with a few simple procedures such as hydration, alkalinization, and drug fractionation, the chemotherapy schemes used can bring about a dramatic improvement in short-term survival.