Treatment of lymphoblastic lymphoma in adults

C. N. Coleman, V. J. Picozzi, R. S. Cox, K. McWhirter, L. M. Weiss, J. R. Cohen, K. P. Yu, S. A. Rosenberg

Research output: Contribution to journalArticlepeer-review

123 Scopus citations


Forty-four adult patients with lymphoblastic lymphoma (BL) were treated according to one of two protocols. Both included induction with cyclophosphamide, doxorubicin, vincristine, prednisone, and L-asparaginase; CNS prophylaxis; and maintenance therapy with methotrexate (MTX) and 6-mercaptopurine. In the second protocol, CNS prophylaxis began earlier than in the first protocol and included cranial irradiation and intrathecal (IT) MTX rather than simultaneous high-dose systemic and IT MTX. The overall response rate was 100% (95% complete). With a 26-month median follow-up, the 1- and 3-year actuarial freedom from relapse (FFR) for the composite patient group was 70% and 56%, respectively. The incidence of CNS relapse was reduced from 31% in the first protocol to 3% in the second protocol (P = .04, Gehan). Patients can be assigned retrospectively to low (n = 19) and high (n = 25) risk prognostic groups, as indicated by a multivariate analysis of pretreatment prognostic factors. High-risk is defined by Ann Arbor stage IV disease with bone marrow or CNS involvement or initial serum lactate dehydrogenase (LDH) concentration of >300 IU/L (normal, <200). FFR of low- and high-risk groups at 5 years are 94% and 19%, respectively (P = .0006). Low-risk patients are highly curable using this approach to adult LBL. More intensive treatment for high-risk patients is warranted.

Original languageEnglish (US)
Pages (from-to)1628-1637
Number of pages10
JournalJournal of Clinical Oncology
Issue number11
StatePublished - 1986
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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