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1. Alebouyeh M, Moussavi F, Haddad-Deylami H, Vossough P: Successful ambulatory treatment of Hodgkin's disease in Iranian children based on German-Austrian DAL-HD 85-90: single institutional results. Ann Oncol; 2005 Dec;16(12):1936-40
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  • [Title] Successful ambulatory treatment of Hodgkin's disease in Iranian children based on German-Austrian DAL-HD 85-90: single institutional results.
  • BACKGROUND: Hodgkin's disease (HD) accounts for 7.5% of childhood malignancies in Iran.
  • In order to minimize chemotherapy toxicity and avoid eventual hospitalization and psychological and financial burdens we have applied since 1988, for the first time in Iran, a treatment regimen based on subsequently revised DAL-HD 85-90 and later GPOH-HD 95 protocols.
  • PATIENTS AND METHODS: During the period 1988-2004, 40 children with HD received DAL/GPOH-HD-adapted treatment; 25 males (62.5%) and 15 females (37.5%) (male/female ratio 1.7; age 4-14 years, mean 8.8).
  • Staging was as follows: stage I; seven (17.5%); II, 11 (27.5%); III, 11 (27.5%); and IV, 11 (27.5%).
  • Stage IA and IIA patients (n = 15) received either OPA x2 (vincristine, prednisolone, doxorubicin) or OPPA x2 or OPEA x2 (vincristine, prednisolone, procarbazine and doxorubicin), the latter receiving etoposide instead of procarbazine, and applied to males.
  • Stages IIB, IIIA/B and IV received OPPA x2, followed by CO(P)P x4 (cyclophosphamide, vincristine, prednisolone in alternate courses and procarbazine).
  • Twenty nine patients (72.5%) received radiotherapy (20-25 Gy); four to the involved field (stage I), 25 to the upper mantel (stage II and also III with either residual or mediastinal mass) and three additionally to spleen and para-aortic lymph nodes.
  • Relapse occurred in eight patients (20%); seven stage IV (MC) and one stage IA (LP) with progression to IIIB.
  • Salvage chemotherapy consisted of MOPP/ABVD hybrid; six patients achieved a second sustained remission and three patients died: two due to relapse and progressive disease and the third one in CR, owing to thrombocytopenic hemorrhage and foudroyant pneumonia.
  • Aside from minor acute toxicities, three patients demonstrated azoospermia at the age of 18 years and one of these patients suffered non-Hodgkin lymphoma as a second malignancy.
  • HD occurred as a second malignancy in two patients with acute lymphoblastic leukemia.
  • CONCLUSIONS: The DAL/GPOH-HD-based treatment approach proved to achieve long-term sustained cure even in children with advanced HD disease.
  • The essentially outpatient diagnosis and treatment modus did not compromise the disease outcome, and was well tolerated and accepted by the patients and their parents.
  • The employed drugs are easily available and affordable.

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  • (PMID = 16157620.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
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2. Reiter A, Schrappe M, Ludwig WD, Tiemann M, Parwaresch R, Zimmermann M, Schirg E, Henze G, Schellong G, Gadner H, Riehm H: Intensive ALL-type therapy without local radiotherapy provides a 90% event-free survival for children with T-cell lymphoblastic lymphoma: a BFM group report. Blood; 2000 Jan 15;95(2):416-21
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  • [Title] Intensive ALL-type therapy without local radiotherapy provides a 90% event-free survival for children with T-cell lymphoblastic lymphoma: a BFM group report.
  • The purpose of our study was to investigate the efficacy of an acute lymphoblastic leukemia (ALL)-type treatment with moderate-dose, prophylactic cranial irradiation and without local radiotherapy for childhood T-cell lymphoblastic lymphoma (T-LBL).
  • From April 1990 to March 1995, 105 evaluable patients, 1.1 to 16.4 years of age, with T-LBL were enrolled in study NHL-BFM 90 (non-Hodgkin's lymphoma-Berlin-Frankfurt-Munster 90).
  • They received an 8-drug induction over 9 weeks followed by an 8-week consolidation including methotrexate (MTX) 5 g/m(2) x 4.
  • Patients with stage I (n = 2) and II (n = 2) continued with maintenance therapy (6-mercaptopurine daily and MTX weekly, both orally) until a total therapy duration of 24 months.
  • Patients with stage III (n = 82) and IV (n = 19) received an 8-drug intensification over 7 weeks and cranial radiotherapy (12 Gy for prophylaxis) after consolidation, followed by maintenance.
  • We conclude that, with intensive ALL-type chemotherapy including moderate cumulative doses of anthracyclines 240 mg/m(2) and cyclophosphamide (3 g/m(2)) and moderate-dose prophylactic cranial irradiation but no local radiotherapy, an event-free survival rate of 90% can be achieved in childhood T-LBL. (Blood.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cranial Irradiation. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / radiotherapy
  • [MeSH-minor] 6-Mercaptopurine / administration & dosage. Adolescent. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Methotrexate / administration & dosage. Neoplasm Staging. Probability. Remission Induction. Time Factors

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  • (PMID = 10627444.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] E7WED276I5 / 6-Mercaptopurine; YL5FZ2Y5U1 / Methotrexate
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3. Attarbaschi A, Mann G, Dworzak M, Trebo M, Urban C, Fink FM, Horcher E, Reiter A, Riehm H, Gadner H, Austrian Cooperative Study Group: Malignant non-Hodgkin's lymphoma of childhood and adolescence in Austria--therapy results between 1986 and 2000. Wien Klin Wochenschr; 2002 Dec 30;114(23-24):978-86
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  • [Title] Malignant non-Hodgkin's lymphoma of childhood and adolescence in Austria--therapy results between 1986 and 2000.
  • Between 1986 and 2000 183 Austrian children and adolescents with non-Hodgkin's lymphoma (NHL) and mature B-cell acute leukemia (B-ALL) were enrolled in 3 consecutive studies of the Berlin-Frankfurt-Münster (BFM) Group.
  • In trial NHL-BFM 86, patients were stratified according to the histologic subtype and clinical stage.
  • Patients with lymphoblastic lymphoma (mainly with T-cell phenotypes) had an excellent prognosis with an ALL-type chemotherapy regimen (n = 49; relapse, n = 1), whereas an intensive, short-pulse therapy delivered within a 2- to 4-month period was found to be highly efficacious in children with B-cell NHL/B-ALL (n = 114; relapse, n = 6; progression, n = 5).
  • Patients with anaplastic large cell lymphoma (ALCL) who were treated with similar alternating short courses of multi-agent chemotherapy had a less good outcome (n = 20; relapse, n = 6, progression, n = 3).
  • Local radiotherapy as a part of lymphoma therapy was completely abandoned in study NHL-BFM 90 and surgical interventions were confined to specific situations such as complete resection in localized B-cell NHL and ALCL, diagnostic biopsy and second-look operation.
  • In conclusion, our results showed that the BFM treatment strategy for lymphoblastic lymphoma and B-cell NHL/B-ALL was highly successful in the majority of patients; however, optimal treatment for children with ALCL has not yet been defined.
  • [MeSH-major] Burkitt Lymphoma / therapy. Lymphoma, Non-Hodgkin / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Data Interpretation, Statistical. Disease-Free Survival. Female. Follow-Up Studies. Humans. Infant. Lymphoma, B-Cell / diagnosis. Lymphoma, B-Cell / drug therapy. Lymphoma, B-Cell / mortality. Lymphoma, B-Cell / therapy. Male. Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy. Prognosis. Prospective Studies. Risk Factors. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 12635465.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study
  • [Publication-country] Austria
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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4. Landman-Parker J, Pacquement H, Leblanc T, Habrand JL, Terrier-Lacombe MJ, Bertrand Y, Perel Y, Robert A, Coze C, Thuret I, Donadieu J, Schaison G, Leverger G, Lemerle J, Oberlin O: Localized childhood Hodgkin's disease: response-adapted chemotherapy with etoposide, bleomycin, vinblastine, and prednisone before low-dose radiation therapy-results of the French Society of Pediatric Oncology Study MDH90. J Clin Oncol; 2000 Apr;18(7):1500-7
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  • [Title] Localized childhood Hodgkin's disease: response-adapted chemotherapy with etoposide, bleomycin, vinblastine, and prednisone before low-dose radiation therapy-results of the French Society of Pediatric Oncology Study MDH90.
  • PURPOSE: The French Society of Pediatric Oncology MDH82 study demonstrated the effectiveness of 20 Gy irradiation of involved fields after doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or mechlorethamine, vincristine, procarbazine, and prednisone/ABVD chemotherapy in children with localized Hodgkin's disease (HD).
  • To reduce long-term treatment complications without compromising efficacy, the MDH90 study was based on a new chemotherapy regimen devoid of both alkylating agents and anthracycline, followed by 20 Gy of radiotherapy (RT) for good responders.
  • Significant predictors of worse event-free survival in multivariate analysis were hemoglobin < 10.5 g/L, "b" biologic class, and nodular sclerosis.
  • CONCLUSION: These results suggest that most children with clinical stage I and II HD can be treated with chemotherapy devoid of alkylating agents and anthracycline, followed by low-dose RT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hodgkin Disease / drug therapy. Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adolescent. Bleomycin / administration & dosage. Child. Child, Preschool. Combined Modality Therapy. Dacarbazine / administration & dosage. Disease-Free Survival. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Prednisone / administration & dosage. Radiotherapy Dosage. Treatment Outcome. Vinblastine / administration & dosage

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  • (PMID = 10735898.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; 6PLQ3CP4P3 / Etoposide; 7GR28W0FJI / Dacarbazine; 80168379AG / Doxorubicin; VB0R961HZT / Prednisone; ABVD protocol; VBVP protocol
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5. Dieckmann K, Pötter R, Hofmann J, Heinzl H, Wagner W, Schellong G, Pediatric Cooperative Hodgkin Disease Study Group of the GPOH: Does bulky disease at diagnosis influence outcome in childhood Hodgkin's disease and require higher radiation doses? Results from the German-Austrian Pediatric Multicenter Trial DAL-HD-90. Int J Radiat Oncol Biol Phys; 2003 Jul 1;56(3):644-52
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  • [Title] Does bulky disease at diagnosis influence outcome in childhood Hodgkin's disease and require higher radiation doses? Results from the German-Austrian Pediatric Multicenter Trial DAL-HD-90.
  • PURPOSE: The identification of risk factors is required for risk-adapted treatment strategies in the treatment of Hodgkin's disease.
  • To assess the influence of bulky disease at diagnosis as compared with other risk factors on event-free survival (EFS) in pediatric Hodgkin's disease such as stage, B-symptoms, number of involved lymph node regions, histology, and remission status after chemotherapy, we analyzed the outcome of 552 patients treated with a risk-adapted treatment strategy consisting of OPPA(OEPA)/COPP (vincristine, procarbazine, etoposide, prednisone, adriamycin, cyclophosphamide) and involved-field radiotherapy.
  • METHODS AND MATERIALS: Between 1990 and 1995, 578 patients with primary Hodgkin's disease (HD) were enrolled in the German/Austrian Pediatric Hodgkin's Disease Study Group (DAL) Multicenter Study (HD-90).
  • Patients were stratified into three treatment groups (TGs) for early, intermediate, and advanced stage.
  • The following prognostic factors were analyzed with regard to their impact on EFS: bulky disease, mediastinal tumor, number of involved lymph node regions, histology, treatment group, B-symptoms, sex, age, and remission status after chemotherapy.
  • RESULTS: Significant univariate predictive factors for the EES were: nodular sclerosis type 2 (NS2) histology (relative risk [RR] 3.43; p = 0.0002), presence of B-symptoms (RR 2.70; p = 0.0014), number of involved regions (1.55; p = 0.019), and treatment groups (RR 1.33; p = 0.017).
  • There was a higher risk (RR 1.92; p = 0.040) for patients with bulky compared with nonbulky disease (5-year EFS 89.6%/94.6%).
  • CONCLUSION: Treatment strategies in Hodgkin's disease have an impact on different risk factors.
  • In the risk-adapted treatment strategy of the HD-90 study, tumor burden indicated as bulky disease or as number of involved lymph nodes loses its importance, whereas NS2 histology and B-symptoms have a major impact on treatment outcome.
  • Bulky disease at diagnosis might require higher radiation doses only in case of insufficient remission.
  • [MeSH-major] Hodgkin Disease / pathology. Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adolescent. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Disease Progression. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Humans. Lymphatic Metastasis. Male. Mediastinal Neoplasms / drug therapy. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / radiotherapy. Neoplasm Staging. Prednisone / administration & dosage. Procarbazine / administration & dosage. Proportional Hazards Models. Radiotherapy Dosage. Recurrence. Remission Induction. Retrospective Studies. Risk Factors. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 12788169.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; VB0R961HZT / Prednisone; COPP protocol; DVPP protocol
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6. Viani GA, Castilho MS, Novaes PE, Antonelli CG, Ferrigno R, Pellizzon CA, Fogaroli RC, Conte MA, Salvajoli JV: Chemotherapy followed by low dose radiotherapy in childhood Hodgkin's disease: retrospective analysis of results and prognostic factors. Radiat Oncol; 2006;1:38
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  • [Title] Chemotherapy followed by low dose radiotherapy in childhood Hodgkin's disease: retrospective analysis of results and prognostic factors.
  • PURPOSE: To report the treatment results and prognostic factors of childhood patients with Hodgkin's disease treated with chemotherapy (CT) followed by low dose radiotherapy (RT).
  • In histological analysis Nodular Sclerosis was the most prevalent type (48%) followed by Mixed Celularity (34.6%).
  • The staging group according Ann Arbor classification was: I (11.7%), II (36.4%), III (32.1%) and IV (19.8%).
  • The standard treatment consisted of chemotherapy multiple drug combination according the period of treatment protocols vigent: ABVD in 39% (n-65) of the cases, by VEEP in 13 %(n-22), MOPP in 13 %(n-22), OPPA-13 %(n-22) and ABVD/OPPA in 22 %(n-33).
  • Radiotherapy was device to all areas of initial presentation of disease.
  • Survival according to clinical stage as 94.7%, 91.3%, 82.3% and 71% for stages I to IV(p = 0,005).
  • Multivariate analysis showed presence of B symptoms, no radiotherapy and advanced clinical stage to be associated with a worse prognosis.
  • CONCLUSION: This data demonstrating the importance of RT consolidation with low dose and reduced volume, in all clinical stage of childhood HD, producing satisfactory ten years OS and EFS.
  • As the disease is highly curable, any data of long term follow-up should be presented in order to better direct therapy, and to identify groups of patients who would not benefit from radiation treatment.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Hodgkin Disease / drug therapy. Hodgkin Disease / radiotherapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Combined Modality Therapy / methods. Drug Therapy / methods. Female. Humans. Male. Prognosis. Radiotherapy / methods. Retrospective Studies. Treatment Outcome

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  • (PMID = 17014708.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Other-IDs] NLM/ PMC1592540
  • [General-notes] NLM/ Original DateCompleted: 20070806
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7. Williams DM, Hobson R, Imeson J, Gerrard M, McCarthy K, Pinkerton CR, United Kingdom Children's Cancer Study Group: Anaplastic large cell lymphoma in childhood: analysis of 72 patients treated on The United Kingdom Children's Cancer Study Group chemotherapy regimens. Br J Haematol; 2002 Jun;117(4):812-20
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  • [Title] Anaplastic large cell lymphoma in childhood: analysis of 72 patients treated on The United Kingdom Children's Cancer Study Group chemotherapy regimens.
  • From June 1990 to June 1998, 72 patients with anaplastic large cell lymphoma (ALCL) were treated with short intensive multi-agent regimens [non-Hodgkin's lymphoma (NHL) 9000 and 9602].
  • Treatment for stage I disease consisted of eight courses (2 x vincristine, doxorubicin, prednisolone; 2 x methotrexate; 2 x cytarabine, thioguanine; and 2 x methotrexate etoposide).
  • For stage II, III and non-central nervous system (CNS) stage IV, two COPADM (cyclophosphamide, doxorubicin, prednisolone, methotrexate, vincristine), two CYM (cytarabine methotrexate) and a COPADM was given.
  • For CNS-positive disease, treatment was intensified and contained methotrexate 8 g/m(2) and cytarabine 3 g/m(2).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Lymphoma, Large-Cell, Anaplastic / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Cyclophosphamide / administration & dosage. Cytarabine / administration & dosage. Disease Progression. Disease-Free Survival. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Follow-Up Studies. Great Britain. Humans. Infant. Male. Methotrexate / administration & dosage. Prednisolone / administration & dosage. Recurrence. Risk. Thioguanine / administration & dosage. Vincristine / administration & dosage

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  • (PMID = 12060115.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; FTK8U1GZNX / Thioguanine; YL5FZ2Y5U1 / Methotrexate
  • [Number-of-references] 26
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