[The treatment results in children diagnosed with non-Hodgkin's lymphomas and acute B-cell lymphoblastic leukemias treated by the BFM protocols. The report of the POGM (Pediatric Oncology Group of Madrid)]. / Resultados del tratamiento de niños diagnosticados de linfomas no Hodgkin y leucemias linfoblásticas agudas de células B tratados con protocolos BFM. Informe del GOPM (Grupo de Oncología Pediátrica de Madrid).

OBJECTIVE: The purpose of this study was to reproduce the results obtained by the "BFM Group" in children with NHL and B-ALL treated with BFM 86 and 90 protocols. PATIENTS AND METHODS: From April 1987 until January 1997, we have treated a total of 82 children, 22 with non-B NHL, 49 B-NHL and 11 B-ALL. Forty-four of them were treated according to BFM 86 and 38 according to BFM 90 protocols. RESULTS: Ninety-four percent of the patients achieved complete remission (CR) and 15% of these relapsed, 12% of the cases of B NHL/ALL and 23% of the non-B NHL. The 5 year overall survival (Kaplan Meier) was 81% for the B NHL/ALL it was 83% and for non-B NHL 77%. The event-free survival was 75% for B-NHL, stages I and II it was 80% and stages II and IV 78%, for B-ALL 72% and for non-B NHL 68%. The median follow-up time was 50 months (12-106). CONCLUSIONS: Treatment of NHL and B-ALL with BFM protocols is an effective therapeutic choice, with reproduction of the results of the "BFM group" being feasible.

[The results of treatment by the Madrid Pediatric Oncology Group according to the BFM protocols in non-Hodgkin's B-cell lymphoma and acute B-cell lymphoblastic leukemia in pediatric patients]. / Resultados del tratamiento según protocolos BFM del linfoma no Hodgkin B y de la leucemia linfoblástica aguda de células B en pacientes pediátricos por el GOPM.

The objective of this report is to present the results of the BFM group in the treatment of 41 children with non-Hodgkin's B cell lymphoma and acute B cell lymphoblastic leukemia according to the BFM 86 and 90 protocols. Forty-one children, between 2 and 16 years of age, were treated from November 1987 to October 1993. Of these, 25 were treated with the BFM 86 protocol (18 non-Hodgkin's B cell lymphomas and 7 acute B cell lymphoblastic leukemias) and the rest with the BFM 90 protocol (15 non-Hodgkin's B cell lymphomas and 1 acute B cell lymphoblastic leukemia). Complete remission was achieved in 97.5% of the patients. A relapse occurred in 12.5% of the cases. Currently, 80.4% remain in continuous complete remission and 17% have died. The 5 year actuarial survival rate of those treated with the BFM 86 and 90 protocols was 79% and 87%, respectively, and event free survival in the same period was 76% and 87%, respectively. There was no statistically significant difference in the results obtained with the two treatment protocols.

[Control of vomiting induced by antineoplastic chemotherapy in childhood]. / Control de la emesis inducida por quimioterapia antineoplásica en la infancia.

Twenty four children aged 2 to 13 years who were to receive cancer chemotherapy were enrolled in a prospective study (before-after-trial) in order to evaluate the efficacy of systematic antiemetic prophylaxis. The regimen of three drugs (metilpednisolone 4 mg/Kg/dose/iv 2 doses; metodopamide 0.5 mg/Kg/dose/iv 4 doses; diphenydramine 1 mg/Kg/dose/iv 4 doses) was used. We found a significative reduction (P less than 0.001) in the incidence of vomiting and nauseousness duration when the antiemetic prophylaxis was used. There were very few and slight adverse effects secondary to antiemetic drugs: Sedation happened in 25% of chemotherapic cycles and hypotension without clinical repercussion in 15%. No patient had distonia. We conclude that systematical antiemetic protection should be used in children receiving chemotherapy. The association of metilpednisolone, metopramide and diphenhydramine is a safe and effective combination.

[Spinal cord compression in children with cancer]. / Síndrome de compresión medular en niños con cáncer.

Metastatic cord compression is a rare complication of malignant diseases in childhood. The most common causes are bone and soft tissue sarcomas, neuroblastoma, lymphoma and leukemia. The clinical manifestations, diagnosis, treatment and evolution of eight children with metastatic cord compression are presented. Diagnosis was based on computerized tomography that was pathological in all the cases, and confirmed by myelography in four patients. The cytological analysis of the cerebrospinal fluid was made in three patients being negative for tumoral cells in all of them. Treatment consisted on radiotherapy, chemotherapy and/or surgery depending on the tumor histology. Decompressive laminectomy was made in patients who did not show previous evidence of cancer. Functional prognosis was related with the degree of disablement at diagnosis and treatment.

[Treatment of infantile acute lymphoblastic leukemia with protocol ALL-BFM 83]. / Tratamiento de la leucemia aguda linfoblástica infantil con el protocolo ALL-BFM 83.

The outcome of 63 children with non-B acute lymphoblastic leukemia treated with ALL-BFM 83 protocol is analyzed. 95% achieved complete remission with the initial treatment. For the entire group the event free survival (EFS) was 66% (+/- 9%) at 48 months. These results were close to those obtained by the BFM group. Haematological toxicity was the main adverse effect, but there where no therapy related deaths. Persistence of more than 1,000 blast cells per microl in peripheral blood after 7th days of prednisone monotherapy, and spleen size greater than or equal to 5 cm under the costal margin, were identified as independent risk factors of high significance. The EFS in patients with poor clinical response to steroids (greater than or equal to 1,000 blast/microl at day 8) was 22% (+/- 18%), instead of 69% (+/- 12%) in those with adequate response.