@CC MTX 3mg, Pred 2.5mg Ara-C 30mg d7
d1,2,3,4 d3,4,5,6
ABMT Pre-conditioning
-8 -7 -6 -5 -4 -3 -2 -1 0
Busulfan 120mg/m* ! ! ! !
Protocol B-Cell-BFM-90
R1 V--A -- B R2 V--AA--BB--CR--AA--BB R3 V--AA--BB--CR--AA--BB--AA--BB
PR--CC--CR--AA--BB--CC PR OP----Negtive
Positive--ABMT
V
1 2 3 45
30mg/m
>2-3umol/L
45mg/m
>3-4umol/L
60mg/m
>4-5umol/l
75mg/m
>5umol/L: CFmg=MTXumol/L/kg
MTX 10%@30’, 90%@23.5h
BB
Dx 10mg/m CTX 200mg/m/1h MTX 5.0g/24h IT Adr 25mg/m/1h
Reinduction No
HD MTX 5/m Cranial RT 1200(III,IV) Yes
5y EFS
78%
90%
BFM 90 B-cell Report
Blood 1999;94:3294
Object:
LDH and early response For group III and LDH > 500 , MTX
from 0.5 to 5.0 2 cycles for complete resected
disease systemic chemo plus intravencular
therapy for CNS positive patiens
Grouping
R1:
CR,
R2:
no-abdomen primary or incompletely resect, LDH <500,
12345 xxxxx xxxxx x x x
CC
12345
Dx 20mg/m
xxxxx
VDS 3mg/m(max 5mg) x
Ara-C 2.0g/m/3h
xx xx
Vp-16 150mg/m/1h
xxx
IT
x
CNS(+) Intraventricularly Chemo
@ AA and BB MTX 3mg, Pred 2.5mg Ara-C 30mg d5
4y EFS >
ALL: 68% vs 55% NHL: 78% vs 64%
POG8704 BFM90
Induction
Daun 50mg Asp30000
Daun 120mg Asp80000
Consolidation Vp16+Ara-c CNS Prophyl Cranial RT
2400(WBC>50000)
0-18y, T-cell, F:M 24:81. 106 patients, I:2, II:2, III:82, IV:19.
BM(+) 15, CNS(+) 3. Protocol:
ALL-like protocol. Induction: CTX 1g/m, d36,64.Re-in d36 HDMTX 5.0g/m/24h X 4. Asp X 2（10000/M x 8，x4） CRT：1200 cGy for III/IV Total CTX 3g, Adr 240mg/m. Total therapy 2 y.
Pred 30mg/m/d x x x x x
CTX 200mg/m/1h x x x x x
I/T
x
A DX 10mg/m/d Ifos 800mg/m/d/1h
123 45 xxx xx x xxxx
MTX 500mg/m/24h* x
IT
x
Ara-c 150mg/m/q12h/1h
xx xx
R3:
abdomen primary, LDH>500 or multiple bone,BM,CNS involvement,6 cycles No-CR after 2 cycles: HDAra-c+Vp-16 for 2 cycles If CR, plus another 3 cycles
Vp-16 100mg/m/1h
xx
*CF 12mg/m @ 48,54h,10%MTX/30’,90%23.5h
B
Dx 10mg/m CTX 200mg/m/1h MTX 500mg/m/24h IT Adr 25mg/m/1h
12345 xxxxx xxxxx x x x
AA
12345
Dx 10mg/m
Result
5y EFS 90%
No different at
Sex, age, LDH(>500), III or IV, immunotyping, d33 CR or not
POG 8704 Report--T-ALLand T-NHL
Leukemia 1999;13:335
xxxxx
Ifos 800mg/m/1h
xxxxx
MTX 5g/m/24h*
x
IT
x
VcR 1.5mg/m
x
Ara-C 150mg/m/1h/q12h
xx xx
Vp-16 100mg/m/d/1h
xx
* CF 30mg @ 42,48h, q6h ajusted as follows:
>1-2umol/L
T-ALL 357caes, T-NHL(lymphoblastic) 195 whole protocol basicly like ALL After CR:
High dose Asp 25000/m/w x 20W from d 99 as consolidation
No high dose Asp consolidation
背景
王耀平教授执笔了第一个儿童淋巴瘤诊疗建议， 至今已10年余。
国际上儿童淋巴瘤的总体的5年无病生NHL Protocol Review
NHL-BFM90 Report (T-LBL) Blood ,2000,95(2):416