Long-term results with the adapted LMB 96 protocol in children with B-cell non Hodgkin lymphoma treated in Iraq: comparison in two subsequent cohorts of patients

Abstract

Since 2000, an adapted LMB 96 protocol was implemented at the Children-Welfare-Teaching-Hospital in Baghdad for the treatment of childhood B-cell non-Hodgkin lymphoma. The first experience (2000–2005) demonstrated efficacy and feasibility of this protocol in Iraq. In 2006, further adjustments were made in an attempt to reduce therapy-related toxicities. The outcome of the second cohort of 190 children (2006–2010) and the comparison with the previous study are hereby reported. Out of the 180 treated patients, 120 achieved a complete response; during treatment 51 died and 9 abandoned. The 60-month overall survival (OS) and event-free survival (EFS) were 64.7 and 56.3%, respectively. No differences were observed in the 24-month OS and EFS between the 2000–2005 and 2006–2010 cohorts (66.3% vs. 65.1%; p = .89 and 53.3% vs. 57.3%; p = .28, respectively). Therapeutic group-B in the second cohort showed better outcome, although not significant, compared to the first one (EFS 62.9% vs. 53.8%; p = .088). Therapy-related mortality remained high.

KEYWORDS:

• B-cell non-Hodgkin lymphoma
• children
• low-income country

Acknowledgements

The authors wish to thank INTERSOS in supporting the transfer of pathology specimens from Baghdad to Rome and for sponsoring and supporting the Telemedicine program between the Children's Welfare Teaching Hospital in Baghdad, Iraq and the Hematology team at the Sapienza, University of Rome, Italy. The authors thank Prof. Luigi Ruco for the kind contribution to the discussion of the pathological diagnosis of the cases.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://doi.org/10.1080/10428194.2018.1519810.