Localized non-Hodgkin's lymphoma with B-cell histology: cure without cyclophosphamide? A report of the United Kingdom Children's Cancer Study Group on studies NHL 8501 and NHL 9001 (1985–1996)


G. A. A. Burke, Specialist Registrar in Paediatric Oncology, Department of Paediatric Oncology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, UK. E-mail: Amos.Burke@Bristol.ac.uk


Summary. We have examined the outcome for children treated on two consecutive United Kingdom Children's Cancer Study Group studies of localized B-cell non-Hodgkin's lymphoma (NHL). The first study (NHL 8501; 1985–1989) included cyclophosphamide in the treatment regimen at a total cumulative dose of 4 g/m2 whereas the regimen in the succeeding study (NHL 9001; 1990–1996) did not include cyclophosphamide. Ninety children with confirmed B-cell NHL were treated in the two studies (NHL 8501, n = 33 and NHL9001, n = 57). With a median follow-up of 7·5 years, overall survival for localized B-cell NHL did not differ between the two regimens with observed 3-year survivals of 94%[95% confidence interval (CI) 80–98%] and 89% (95% CI 79–95%) respectively (P = 0·47). There was also no difference in the event-free survival between children treated on regimen NHL 8501 and NHL 9001 [91% (95% CI 76–97%) vs 84% (95% CI 73–92%) after 3 years; P = 0·34]. Although the difference in the number of failed remissions between NHL 8501 and 9001 (0/33 vs 6/57) approached statistical significance (P = 0·08, Fisher's exact test), there was no overall statistical difference between the treatment failures on either regimen (P = 0·34). Substantial long-term survival can be achieved for many children with localized B-cell NHL without the use of cyclophosphamide. Further studies are needed to identify whether all clinical or histopathological subgroups will benefit equally from the omission of cyclophosphamide.