Sandlund JT et al. - In a trial to evaluate the activity and toxicity of dexamethasone, high-dose cytarabine, and carboplatin (DAC) combination therapy in children with newly diagnosed large-cell non-Hodgkin lymphoma (NHL) and to estimate the event-free and overall survival (OS) rates achieved when DAC is incorporated into a conventional regimen, it was found that the DAC regimen is well tolerated and effective for pediatric pts with large-cell NHL Methods
20 boys and 5 girls aged 4.2 to 17.7 years who had stage III or stage IV large-cell NHL were treated
DAC therapy was administered at the beginning of the induction phase in 2 sequential cycles and incorporated throughout a continuation phase (modified from the ACOP+ regimen, which features doxorubicin, cyclophosphamide, vincristine, and prednisone) with doxorubicin, cyclophosphamide, vincristine, and dexamethasone
Total duration of treatment was approximately 10 months
Results
DAC therapy yielded a response in 22 of 25 pts: complete remission in 13 cases, and partial response in 9
After additional treatment with doxorubicin, cyclophosphamide, vincristine, and dexamethasone, complete remission was attained in 18 pts and partial remission in 3
Event-free survival rate was 64% and the OS rate was 80% at 5 years
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