intensification therapy of mature b-all, burkitt and burkitt like and other high grade non-hodgkin's lymphoma in adults

Conditions: Acute Lymphoblastic Leukemia; Non-Hodgkin's Lymphoma

Summary: all patients are treated according to the same therapy regimen. therapy duration (number of cycles) and radiotherapy vary according to age group, stage and response. chemotherapy consists of a pre-phase-treatment (for all patients) and varying a, b and c cycles. therapy for patients in the 18-55 age group * patients in stages iii-iv and all patients with mediastinal tumors or extranodal involvement are administered 6 cycles (a1, b1, a2, b2, a3, b3). * chemotherapy is stopped after 4 cycles (a1, b1, a2, b2) for patients with stage i/ ii if a clear cr has been achieved and there is initially no mediastinal or extranodal involvement. * in cases of refractory or progressive disease after 4 cycles, study therapy is stopped. these patients are to be given salvage therapy with subsequent stem cell transplantation. therapy for patients older than 55 years * the course corresponds to that of patients in the younger age group, but the regimen is dose reduced (a1\*, b1\*,a2\*, b2\*, a3\*, b3\*). antibody therapy with anti-cd20 is to be administered on day 1 of each chemotherapy cycle (a, b). after end of chemotherapy (6 or 4 cycles) 2 more cycles of anti-cd 20 are to be administered to reach a total number of 8 resp. 6 cycles antibody therapy.


Eligibility criteria:
inclusion criteria: * acute lymphoblastic leukemia of the mature b-cell type (l3-all) * high-grade non-hodgkin's lymphoma of the following subtypes (who classification) * burkitt's lymphoma (including atypical burkitt's lymphoma) * precursor b-lymphoblastic lymphoma * anaplastic large-cell lymphoma (ki1+, b-, t- oder null-cell-type) * mediastinal large b-cell-lymphoma (subtype of diffuse large b-cell lymphoma) * age = 18 years * patient's informed consent exclusion criteria: * serious complications caused by leukemia/ lymphoma or by a second illness: e.g. * severe, unmanageable complications such as sepsis, pneumonia with oxygen deficiency, * shock, hemorrhage at the time of diagnosis * renal insufficiency from leukemia/lymphoma-unrelated causes * severe cardiac or hepatic insufficiency * severe obstructive or restrictive lung disease that would compromise patient's treatment with intensified chemotherapy * hiv infection * secondary lymphoma following prior chemotherapy/ radiotherapy or an active second malignancy * known severe allergy to foreign proteins * cytostatic pretreatment for b-all/lymphoma (exceptions: short-term administration of steroids = 7 days, single administration of vincristine or cyclophosphamide, one cycle of chop, a single administration in an emergency of other cytostatic agents) for another malignant disease within the last 5 years * pregnancy/ nursing period * severe psychiatric illness or other circumstances giving ground to the assumption that a patient cannot give his consent to therapy or act co-operatively * absence of patient's informed consent * participation in another clinical study that would possibly interfere with study therapy

Keywords: acute lymphoblastic leukemia of the mature b-cell type high-grade non-hodgkin's lymphoma