First experience with the modified program NHL-BFM-90 application in adult patients with primary diffuse large B-cell gastric lymphosarcoma with unfavourable prognosis

• Published in: Terapevtic̆eskii arhiv Vol. 78; no. 7; p. 38
• Main Authors: Zvonkov, E E, Krasil'nikova, B B, Makhinia, V A, Kaplanskaia, I B, Kravchenko, S K, Karagiulian, S R, Grzhimolovskiĭ, A V, Kuznetsov, A N, Magomedova, A U, Shukhman, I M, Bariakh, E A, Giliazitdinova, E A, Gubkin, A V, Lorie, Iu Iu, Kremenetskaia, A M, Vorob'ev, A I
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2006
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Disease Progression; Drug Administration Schedule; Endoscopy, Gastrointestinal; Female; Humans; Lymphoma, B-Cell - drug therapy; Lymphoma, B-Cell - pathology; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - pathology; Middle Aged; Prognosis; Remission Induction; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology
• ISSN: 0040-3660

To assess efficacy of a modified program NHL-BFM-90 in adult patients with primary diffuse large B-cell gastric lymphosarcoms (PDLBGL) with unfavourable prognosis. Modified courses of NHL-BFM-90 were conducted in 5 patients aged 27-67 years from January 2004 to September 2005. Four patients received chemotherapy of the first line, in one patient block therapy followed monotherapy with chlorambucil and a CHOEP course. All the patients were in a severe clinical condition and had several initial factors of unfavourable prognosis: size of the tumor more than 10 cm; stage IE and more advanced; B-symptoms; proliferative activity above 70%. The program NHL-BFM-90 was modified because of the patients' age. Chemotherapy was conducted according to the middle arm of the original program NHL-BFM-90, but methotrexate was introduced in a dose 1 g/m2 for 12 hours, while leukovorin was given 18 hours after the start of methotrexate injection. In two cases the blocks were enhanced with rituximab, 2 patients had doxorubicin in block A, in one case block C was enhanced with methotrexate. A total of 23 modified blocks NHL-BFM-90 were performed: one patient was given 6 blocks, two patients--5, one patient--4 blocks and one patient--3 blocks. Four patients after block 2 and one patient after block 3 of polychemotherapy NHL-BFM-90 achieved remission of the disease of 6 to 22 months duration which still continues. Infectious complications related to hematological toxicity arose more frequently at the latest courses of chemotherapy. Treatment according to the modified program NHL-BFM-90 in adult patients with PDLBGL and unfavourable prognosis is highly effective. For a mean follow-up of 10.2 months no recurrences occurred. The number of courses can be reduced to decrease accumulated hematological toxicity and in case of rapid achievement of remission.