Cancer Res Treat.  2020 Apr;52(2):573-585. 10.4143/crt.2019.542.

A Modified NHL-BFM-95 Regimen Produces Better Outcome ThanHyperCVAD in Adult Patients with T-Lymphoblastic Lymphoma,a Two-Institution Experience

• Li C
• Wuxiao ZJ
• Chen X
• Chen G
• Lu Y
• Xia Z
• Liang Y
• Wang H

• KMID: 2500342
• DOI: http://doi.org/10.4143/crt.2019.542

Abstract

Purpose
Lymphoblastic lymphoma (LBL) is an invasive neoplasm of precursor T-cell or B-cell lineage. A broadly accepted standard treatment for adult LBL has not yet been defined.
Materials and Methods
To address this issue, we compared two chemotherapy regimens: a modified non-Hodgkin lymphoma Berlin–Frankfurt–Mu!nster-95 (NHL-BFM-95) regimen and HyperCVAD/MA. This retrospective study consecutively enrolled 207 adult LBL patients at two hospitals from 2000 to 2018. Univariate and multivariate analysis were used to assess prognostic factors.
Results
In the present study, most clinical characteristics were similar between the two treatment groups except for age and lactate dehydrogenase (LDH) level. Patients treated with modified NHL-BFM-95 regimen tended to be younger and with elevated LDH level. The modified NHLBFM- 95 regimen produced better treatment outcomes than those with HyperCVAD/MA in patients with T-LBL or patients < 40 years. Treatment with HyperCVAD/MA, high Eastern Cooperative Oncology Group scores, and bone marrow involvement were independent risk factors in T-LBL. No patients interrupted treatment for severe adverse events.
Conclusion
The results suggested that the modified regimen is well-tolerated and can produce the promising outcomes in patients with T-LBL or patients < 40 years.

Keyword

Lymphoblastic lymphoma; Adult; Prognosis; Treatment; Modified NHL-BFM-95 regimen

Figure

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  Fig. 1. (A, B) Kaplan-Meier curves for overall survival (OS) (A) and progression-free survival (PFS) (B) among 207 patients with lymphoblastic lymphoma (LBL). (C, D) Kaplan-Meier curves comparing OS (C) and PFS (D) between patients who received modified NHL-BFM-95 (non-Hodgkin lymphoma Berlin–Frankfurt–Münster-95) and HyperCVAD/MA (hyperfractionated cyclophosphamide, vincristine, adriamycin, dexamethasone/methotrexate, and cytarabine).

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  Fig. 2. Kaplan-Meier curves comparing overall survival (OS) and progression-free survival (PFS) between patients receiving modified NHL-BFM-95 (non-Hodgkin lymphoma Berlin–Frankfurt–Münster-95) regimen and those receiving HyperCVAD/MA (hyperfractionated cyclophosphamide, vincristine, adriamycin, dexamethasone/methotrexate, and cytarabine) according to different cell lineages. (A) OS of patients with T-LBL (p=0.006). (B) PFS of patients with T-LBL (p=0.004). (C) OS of patients with B-LBL (p=0.329). (D) PFS of patients with B-LBL (p=0.510).

• 

  Fig. 3. Kaplan-Meier curves comparing overall survival (OS) and progression-free survival (PFS) between patients receiving modified NHL-BFM-95 (non-Hodgkin lymphoma Berlin–Frankfurt–Münster-95) regimen and those receiving HyperCVAD/MA (hyperfractionated cyclophosphamide, vincristine, adriamycin, dexamethasone/methotrexate, and cytarabine) according to age. (A) OS of adolescent and young adult population (p=0.001). (B) PFS of adolescent and young adult population (p=0.001). (C) OS of patients > 40 years (p=0.899). (D) PFS of patients > 40 years (p=0.894).

Reference

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