Comparing the effectiveness and safety between R-CHOP and modified NHL-BFM-90 regimens in children and adolescents with diffuse large B-cell lymphoma.

This study compared the effectiveness and safety of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) and modified non-Hodgkin lymphoma (NHL) Berlin-Frankfurt-Münster-90 (NHL-BFM-90; cyclophosphamide, vincristine, ifosfamide, etoposide, adriamycin, methotrexate, vindesine, dexamethasone, cytarabine) regimens in children and adolescents with diffuse large B-cell lymphoma (DLBCL). The data showed that the modified NHL-BFM-90 regimen was more effective than R-CHOP in DLBCL patients with advanced-stage disease. However, the R-CHOP regimen might be an option for patients with early-stage DLBCL.

Non-Hodgkin lymphoma (NHL) is a cancer that starts in white blood cells called lymphocytes. These are a part of the body’s immune system. DLBCL is the most common type of NHL. It is mostly diagnosed in older people. At present, the treatment protocols for children and adolescent DLBCL patients are not standardized.

The treatment strategies for adult and pediatric patients are different. The most common treatment for adult patients involves the chemotherapy regimen called R-CHOP. Modified NHL-BFM-90 is an effective treatment regimen for DLBCL in children and adolescents. However, the effectiveness and safety of R-CHOP and modified NHL-BFM-90 regimens in children and adolescents with DLBCL are still unknown.

This study involved 85 patients under the age of 18 years with DLBCL. 74 patients received the modified NHL-BFM-90 regimen and 11 patients received the R-CHOP regimen. The average follow-up time was 67 months.

After 5 years, 91% of patients in the NHL-BFM-90 group were alive compared to 90.9% of patients in the R-CHOP group. After 5 years, 89.8% of patients in the NHL-BFM-90 group were alive without any complications from DLBCL compared to 68.6% of patients in the R-CHOP group.

In patients with advanced-stage disease, 87.1% of patients in the NHL-BFM-90 group were alive compared to 83.3% of patients in the R-CHOP group. 85.4% of patients in the NHL-BFM-90 group were alive without any complications from DLBCL compared to 44.4% of patients in the R-CHOP group.

In patients with early-stage disease, the overall survival rate and the survival rate without any complications of DLBLC were 100% in both groups.

The survival outcomes of the 2 regimens in children or adolescent patients were not significantly different. The frequency of severe side effects from the two regimens was similar.

This study concluded that the modified NHL-BFM-90 regimen was more effective than R-CHOP in DLBCL patients with advanced-stage disease. However, the R-CHOP regimen might be an option for patients with early-stage DLBCL.

This study looked back in time at medical records. The sample size was very small and was not randomized. This study only included patients treated at a single institution in China.