Patients treated for B-cell non-Hodgkin lymphoma (NHL) using the Lymphome Malin de Burkitt (LMB) chemotherapy protocol showed similar health outcomes over time compared with patients on a non-LMB regimen, with the exception of higher levels of neurotoxicity among survivors treated with LMB, according to research reported in the Journal of Clinical Oncology.
This study was a long-term analysis of outcomes for survivors of NHL who were included in the retrospective Childhood Cancer Survivor Study. The analysis included 126 patients treated with the LMB protocol, 444 patients treated with a non-LMB regimen, and 1029 siblings of patients.
Survivors in the LMB group had been diagnosed with NHL at a median age of 10.2 years, and they were assessed at a median age of 24.0 years. Median age at diagnosis for those in the non-LMB group was 10.5 years, and median age at time of evaluation was 29.2 years.
Chronic health conditions were generally more common among NHL survivors compared with siblings.
Survivors of NHL treated with either LMB or non-LMB regimens showed similar health overall. However, survivors treated with LMB therapy experienced greater severity regarding various neurological outcomes.
Among survivors of NHL, the relative risk (RR) of epilepsy with LMB therapy compared with non-LMB therapy was 15.2 (95% CI, 3.1-73.4). The RR of balance problems with LMB therapy was 8.9 (95% CI, 2.3-34.8), and for leg weakness the RR was 8.1 (95% CI, 2.5-26.4). Other neurologic conditions that showed greater incidence with LMB compared with non-LMB therapy included tremors, severe headaches, and prolonged pain in a limb or the back.
“In summary, the successful LMB chemotherapy regimen has not substantially increased overall morbidity but has altered the spectrum of health conditions experienced by survivors of mature B-cell lymphoma,” wrote the investigators. They indicated the study’s results could help drive improvements in LMB therapy.
- Ehrhardt MJ, Chen Y, Sandlund JT, et al. Late health outcomes after contemporary Lymphome Malin de Burkitt therapy for mature B-cell non-Hodgkin lymphoma: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2019;37:2556-2570.