What are the German Berlin, Frankfurt, Muenster (BFM) protocols for the treatment of pediatric lymphoblastic lymphoma?

Updated: Jun 14, 2018
  • Author: J Martin Johnston, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

The German Berlin, Frankfurt, Muenster (BFM) protocols have demonstrated excellent results in patients with ALL or lymphoblastic lymphoma. (See Table 2, below.) [62]

Unlike the LSA2 L2 protocol, the BFM regimen has a reinduction phase. It also features a less complicated and less intense maintenance phase. In its original report, the BFM protocol included prophylactic cranial irradiation during reinduction. Patients receiving this treatment had a 6-year event-free survival rate of 79%.

Table 2. Therapy for Stage III and IV Non–B-Cell Disease* According to BFM Protocol 86 (Open Table in a new window)

Phases

Drug

Route

Induction

Prednisone, 6-mercaptopurine

PO

Vincristine, daunorubicin, cyclophosphamide, Ara-C

IV

L-asparaginase

IM

Methotrexate

IT

Consolidation

6-mercaptopurine

PO

Methotrexate with leucovorin rescue

IV

Methotrexate

IT

Re-induction

Dexamethasone, 6-thioguanine

PO

Vincristine, doxorubicin, cyclophosphamide, Ara-C

IV

L-asparaginase

IM

Methotrexate

IT

Maintenance

6-mercaptopurine, methotrexate

PO

Source: Berlin-Frankfurt-Munster Group

Ara-C = cytarabine; IT = intrathecal; IV = intravenous; PO = oral; SC = subcutaneous

* Diagnoses included lymphoblastic lymphoma of the T-cell or precursor B-cell type, immunoblastic T-cell lymphoma, and other peripheral T-cell lymphomas. Of note, patients with Ki-1+ anaplastic large cell lymphomas (LCLs) were not included.

Continued until 24 months after diagnosis.


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