Outcome of relapsed or refractory childhood B‐cell acute lymphoblastic leukaemia and B‐cell non‐Hodgkin's lymphoma treated with the UKCCSG 9003/9002 protocols

Abstract

Twenty‐six children with B‐cell acute lymphoblastic leukaemia (B‐ALL) or Murphy Stage III or IV B‐cell non‐Hodgkin's lymphoma (B‐NHL) progressed or relapsed after first‐line therapy with a short, intensive multiagent chemotherapy regimen [United Kingdom Childhood Cancer Study Group (UKCCSG) 9003] (n = 62) or a slightly less intensive regimen (UKCCSG 9002) (n = 112). Eight patients (4·6%) never achieved complete remission (CR) and 18 (10·3%) relapsed. Second‐line therapy resulted in remission for eight patients (30%). All patients initially treated with the 9003 protocol died. Three patients (11·5%) in the 9002 group, including one who never achieved CR in the primary site, are alive after second‐line therapy. This study confirms that the prognosis of relapsed or refractory B‐ALL/B‐NHL is poor and exceptionally so if relapse occurred less than 6 months from diagnosis. High‐dose therapy with stem cell rescue was used in only seven patients; its role needs to be studied further.