Long-Term Health Outcomes After Lymphome Malin de Burkitt Chemotherapy for Pediatric Mature B-Cell Non-Hodgkin Lymphoma
In a study reported in the Journal of Clinical Oncology, Ehrhardt et al found that long-term health outcomes were comparable in patients receiving contemporary Lymphome Malin de Burkitt (LMB) vs non-LMB chemotherapy regimens for pediatric mature B-cell non-Hodgkin lymphoma, except for adverse neurologic effects. The report was based on findings from the Childhood Cancer Survivor Study.
As stated by the investigators, “The widely used, risk-based … LMB chemotherapy regimen has improved survival rates for children with mature B-cell … non-Hodgkin lymphoma; however, associated late effects remain understudied.”
Study Details
The study assessed long-term outcomes among Childhood Cancer Survivor Study 5-year survivors treated between 1970 and 1999 with LMB regimens (n = 126), survivors treated with non-LMB regimens (n = 444), and siblings (1,029). LMB-treated survivors were a median age of 10.2 years at diagnosis and 24.0 years at evaluation.
Long-Term Health Outcomes
Compared with siblings, LMB-treated survivors were at increased risk for numerous adverse health outcomes.
On multivariate analysis, LMB-treated and non–LMB-treated survivors did not differ significantly in risk for infertility; obesity; cataracts; hypothyroidism; cardiomyopathy; stroke; growth hormone deficiency; osteoporosis; problems with eating; weakness in arms; sensory neuropathy; migraines; neurocognitive deficits; or poorer socioeconomic outcomes.
However, LMB-treated survivors were at significantly increased risk vs non–LMB-treated survivors for neurologic conditions consisting of epilepsy (relative risk [RR] = 15.2, P < .001); balance problems (RR = 8.9, P = .002); tremors (RR = 7.5, P = .004); weakness in legs (RR = 8.1, P < .001); severe headaches (RR = 3.2, P < .001); and prolonged pain in the arms, legs, or back (RR = 4.0, P < .001).
The investigators concluded, “Survivors [of pediatric mature B-cell non-Hodgkin lymphoma] treated with LMB and non-LMB regimens are largely comparable in late health outcomes, except for excess neurotoxicity among LMB survivors. These data inform treatment efforts seeking to optimize disease control while minimizing toxicity.”
Matthew Ehrhardt, MD, of the Departments of Oncology and Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by National Cancer Institute grants and the American Lebanese Syrian Associated Charities. For full disclosures of the study authors, visit jco.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
