Results
Four consecutive patients aged between 4 and 13 years at initial
diagnosis were treated. The disease relapse was confirmed through biopsy
in all 4 patients. All the patients were initially treated according to
CCCG-BNHL-2010 (a 6-month chemotherapy regimen combining vincristine,
doxorubicin, cyclophosphamide, prednisone, high-dose methotrexate,
etoposide, and triple intrathecal therapy) [8].
All 4 patients achieved a CR after 2 cycles of weekly
vinorelbine.
Patients 1 and 2 underwent autologous hematopoietic stem-cell
transplantation (HSCT) afterwards, and both had a second relapse, 18
months and 24 months after the first one, respectively. Fortunately,
those 2 patients achieved their CR3 after receiving 3 cycles of
multiagent chemotherapy combined with crizotinib. Both refused further
allogeneic HSCT but continued on crizotinib and remained in CR3 at last
evaluation. Patient 3 underwent allogeneic HSCT afterwards and remained
in his CR2. Patient characteristics, treatments, and outcomes are shown
in Table 1.
The main toxicity related to weekly vinorelbine was hematologic. In
total, 4 patients received 24 cycles of weekly vinorelbine. Table 2
summarizes the grade 3 and 4 toxic effects. Only 1 week of vinorelbine
administration was withheld, for a grade 4 neutropenia in Patient 1.