LAUSR

The most common chemotherapy backbone for children with mature B-non Hodgkin lymphoma (B-NHL), Burkitt’s lymphoma (BL), and diffuse large B-cell lymphoma includes short intensive therapy including steroids, high dose methotrexate, fractionated cyclophosphamide, anthracycline, and intrathecal prophylaxis/treatment, which we established based on the French-American-British (FAB) (FAB LMB 96) studies in the mid-1990s [1–3]. While the cure rate with this approach in good risks patients is high (≥95% 5 year event free survival [EFS]), there is a substantial burden of short-term toxicity (i.e., hospitalization for febrile neutropenia and grade III/IV mucositis) and longterm toxicity including rates of second malignancies [1–5]. Anthracycline cumulative exposure (dose intensity) is a major risk factor for cardiovascular long-term morbidity [6]. The FAB intermediate risk treatment schema requires 9 intrathecal injections, procedural conscious sedations and diagnostic lumbar punctures, which are a risk factor for late neurocognitive deficits [3, 7]. We demonstrated the feasibility of adding dose-dense rituximab (two doses per induction cycles 48 h apart) to advanced stage III/IV, FAB group B and all group C mature B-NHL patients without modification of the chemotherapy backbones [8, 9]. We demonstrated rituximab to be safe and associated with an increased EFS in both advanced mature B-NHL cohorts over historical controls [8, 9]. In this study Presented in part at the Sixth International Symposium on Childhood, Adolescent and Young Adult non-Hodgkin lymphoma, 2018, Rotterdam, Netherlands.