What are the Children's Oncology Group 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 most recent Children's Oncology Group phase 3 protocol (A5971) for children with advanced-stage T-cell lymphoblastic lymphoma featured a 4-way randomization between (1) BFM therapy, (2) a Children's Cancer Group modified version of BFM therapy (which did not include high-dose methotrexate/leucovorin during consolidation), and (3) intensified versions of these 2 protocols (with early introduction of daunomycin and cyclophosphamide). In patients with disseminated disease, there was no statistical difference in outcomes among the 4 groups, with 5-year event-free survival of approximately 81%. Age younger than 10 years and imaging response at 2 weeks were associated with better overall survival. [63]

The Children's Oncology Group is conducting specific protocols to treat T-lymphoblastic lymphoma and T-cell ALL. In particular, current clinical trials will examine the role of nelarabine (previously known as compound 506U78), a prodrug of the deoxyguanosine analog 9-beta-D-arabinofuranosylguanine (Ara-G) that has shown efficacy in T-cell malignancies.


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