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Inpharma 1297 - 21 Jul 2001

DECAL regimen effective inrecurrent NHL and HD

A regimen consisting of dexamethasone, etoposide,cisplatin, high-dose cytarabine and asparaginase(DECAL) is effective for the treatment of children withrecurrent non-Hodgkin’s lymphoma (NHL) orHodgkin’s disease (HD), according to the results of theChildren’s Cancer Group Study CCG-5912.

The US study included 97 children with recurrentNHL (n = 68) or HD. As induction chemotherapy, 2cycles of the following regimen were given at 3-weekintervals: IV dexamethasone 10 mg/m2, etoposide 100mg/m2 and cytarabine 3000 mg/m2 at hours 0, 12, 24and 36; IM asparaginase 25 000 U/m2 at hour 39; and IVcisplatin 90 mg/m2 at hour 42. After induction, patientsreceived up to 4 courses of maintenance chemotherapygiven at 3-week intervals, including a cycle of ifosfamide1800 mg/m2, mesna 360 mg/m2 and etoposide 100mg/m2 daily for 5 days alternating with a cycle of DECAL,or bone marrow transplantation.

After 2 cycles of DECAL induction therapy, the totalresponse rate was 58.5% (40.2% complete and 18.3%partial responses). The response rate for patients withNHL was 50% (39.7% complete and 10.3% partial) andfor those with HD 79.2% (41.7% complete and 37.5%partial). At 5 years, the estimated event-free survival ratewas 23% in patients with NHL and 26% in those withHD, and the estimated overall survival rates were 30 and31%, respectively.

Grade 3 or 4 toxicity was observed in 72% of patientsafter DECAL induction therapy and 70% after DECALmaintenance therapy. The most common events werepancytopenia and systemic infections.Kobrinsky NL, et al. Outcomes of treatment of children and adolescents withrecurrent non-Hodgkin’s lymphoma and Hodgkin’s disease with dexamethasone,etoposide, cisplatin, cytarabine, and L-asparaginase, maintenance chemotherapy,and transplantation: Children’s Cancer Group Study CCG-5912. Journal of ClinicalOncology 19: 2390-2396, 1 May 2001 800867643

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Inpharma 21 Jul 2001 No. 12971173-8324/10/1297-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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