TWO-DECADE EXPERIENCE AND LONG-TERM SURVIVAL IN PEDIATRIC NON-HODGKIN'S LYMPHOMA
INTRODUCTION: Treatment results for pediatric non-Hodgkin's lymphoma (NHL) continue to improve internationally.
OBJECTIVE: Our goal was to evaluate patient characteristics in our series of patients with NHL and outcomes for the last 16 years (1990–2006).
METHODS: Our patients included 52 newly diagnosed children (11 girls) with a median age of 8.40 years (range: 0.33–14.5 years). Histology results included B-lymphocyte NHL, T-lymphocyte NHL, and Ki-1 in 35, 12, and 5 patients, respectively. In each 5-year period, 14 (3), 17 (3), and 21 (5) patients (girls) were diagnosed, respectively. Common presenting sites were the mediastinum (16), neck area (14), and abdomen (10). Disease was at stage I, II, III, and IV in 3, 14, 23, and 7 patients, respectively. Treatment varied over time. Berlin-Frankfurt-Munich (BFM) protocols had been applied since 1995 (BFM-NHL-90), and since 1997 the BFM-NHL-95 protocol had been applied. Irradiation was given to 5 patients (2 with B-NHL, 3 with T-NHL), and autologous stem cell transplantation was performed on 4 patients, all with B-NHL (1 with central nervous system disease, 1 with residual disease at the end of treatment, and 2 at relapse).
RESULTS: At this writing, 41 patients are alive; 39, 2, and 1 are in first, second, and third remission, respectively. In total, 9 have succumbed (2 died soon after admission in other hospitals as a result of acute-phase complications), and 5 patients died during the first decade of our retrospective study (with T-histology and extensive disease). The event-free survival rate is 74.4% (39 of 52 patients), and the overall survival rate is 80.9% (41 of 52 patients), for a median follow-up time of 6.1 years (range: 0.01–14.7 years) for all patients. For the 39 patients treated with the BFM-95 protocol since 1997, event-free survival and overall survival rates are 79.4% and 88.2%, respectively, for a median follow-up time of 4.8 years.
CONCLUSIONS: Overall and event-free survival rates and outcome of our patients with NHL treated during the last 16 years are standing high. There has been limited use of irradiation and stem cell transplantation.
Submitted by Sophia Polychronopoulou
- Copyright © 2008 by the American Academy of Pediatrics