{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:12:00Z","timestamp":1792005120124,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T00:00:00Z","timestamp":1695427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Pediatric B\u2010cell non\u2010Hodgkin lymphomas (NHL) in low\u2010 and middle\u2010income countries (LMICs) have historically had inferior outcomes due to higher treatment\u2010related mortality (TRM) and relapses. To address this issue, we evaluated the impact of reducing chemotherapy dose intensity by 25% and adding rituximab on outcomes in pediatric B\u2010NHL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Patients, less than 18\u00a0years of age with group B and C disease as per the Lymphome Malin de Burkitt (LMB) risk stratification were enrolled between September 2017 and October 2022. The LMB\u201089 protocol, with a 25% reduction in all chemotherapy doses and the addition of rituximab, was administered. The response was assessed using positron emission tomography with computed tomography (PET\/CT) after four cycles of chemotherapy (interim) and at the end of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 25 patients with a median age of 6.9\u00a0years, among whom 20 (80%) were males. Twenty patients had group B and five had group C disease. Complete metabolic response (CMR) was achieved by 22\/25 (88%) patients, and three (12%) achieved partial metabolic response (PMR) in the interim PET\/CT. At the end of treatment, 22\/24 (92%) patients achieved CMR, one had PMR, and one had progressive disease. The median follow\u2010up was 45\u00a0months (range: 3\u201371\u00a0months). The 4\u2010year event\u2010free survival and overall survival were 88% and 92%, respectively. There were two deaths, one due to disease progression and the other due to sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study demonstrates a significant improvement in outcomes in pediatric B\u2010NHL compared to previous reports from LMICs, achieved through a 25% reduction in chemotherapy dose intensity and the addition of rituximab.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30694","type":"journal-article","created":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T07:25:16Z","timestamp":1695453916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Reducing chemotherapy dose intensity by 25% and adding rituximab improves survival in pediatric mature B\u2010cell non\u2010Hodgkin lymphoma in LMIC setting"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7557-5816","authenticated-orcid":false,"given":"Venkatraman","family":"Radhakrishnan","sequence":"first","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatakrishnan","family":"Kritthivasan","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji Thiruvengadam","family":"Kothandan","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanth","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4596-2820","authenticated-orcid":false,"given":"Gargi","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0446-7260","authenticated-orcid":false,"given":"Jaikumar","family":"Ramamurthy","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology Cancer Institute (WIA), Adyar  Chennai Tamil Nadu India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.5827"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17979"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15785"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14030"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phoj.2019.08.019"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-017-2318-0"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V97.11.3370"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.2.186"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915315"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-017-3690-8"},{"key":"e_1_2_10_12_1","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE) | Protocol Development.Cancer Therapy Evaluation Program (CTEP); NCI. 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