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J Clin Oncol. 2015 Sep 20;33(27):2963-74. doi: 10.1200/JCO.2014.59.5827. Epub 2015 Aug 24.

Non-Hodgkin Lymphoma in Children and Adolescents: Progress Through Effective Collaboration, Current Knowledge, and Challenges Ahead.

Author information

1
Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels.
2
Véronique Minard-Colin, Laurence Brugières, Anne Auperin, Marie-Cécile Le Deley, and Catherine Patte, Institut Gustave Roussy, Villejuif; Martine Raphael, Centre National de la Recherche Scientifique UMR 8126, Université Paris Sud; Elizabeth Macintyre, Université Paris Descartes Sorbonne Cité, Institut Necker-Enfants Malades, Institut National de Recherche Médicale U1151, and Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris; Laurence Lamant, Institut Universitaire du Cancer Toulouse Oncopole and Université Paul-Sabatier, Toulouse, France; Alfred Reiter, Wilhelm Woessmann, and Christine Damm-Welk, Justus-Liebig-University Giessen, Giessen; Birgit Burkhardt, Children University Hospital, Münster; Martin Zimmerman, Medizinische Hochschule, Hannover; Wolfram Klapper, Christian-Albrechts-University Kiel, Kiel, Germany; Mitchell S. Cairo, New York Medical College, Valhalla, NY; Thomas G. Gross, National Cancer Institute, Bethesda, MD; John T. Sandlund, St Jude Children's Research Hospital and University of Tennessee Health Science Center, College of Medicine, Memphis, TN; Sherrie L. Perkins, University of Utah Health Sciences, Salt Lake City, UT; Denise Williams, Cambridge University Hospitals Foundation Trust, Cambridge, United Kingdom; Marta Pillon and Angelo Rosolen, University of Padova, Padova; Lara Mussolin, Istituto di Ricerca Pediatrico-Fondazione Cittàdella Speranza and University of Padua, Padua, Italy; Keizo Horibe, National Hospital Organization Nagoya Medical Center, Nagoya, Japan; and Hélène A. Poirel, Center for Human Genetics, Cliniques Universitaires Saint-Luc-Université Catholique de Louvain, Belgium, Brussels. catherine.patte@gustaveroussy.fr.

Abstract

Non-Hodgkin lymphoma is the fourth most common malignancy in children, has an even higher incidence in adolescents, and is primarily represented by only a few histologic subtypes. Dramatic progress has been achieved, with survival rates exceeding 80%, in large part because of a better understanding of the biology of the different subtypes and national and international collaborations. Most patients with Burkitt lymphoma and diffuse large B-cell lymphoma are cured with short intensive pulse chemotherapy containing cyclophosphamide, cytarabine, and high-dose methotrexate. The benefit of the addition of rituximab has not been established except in the case of primary mediastinal B-cell lymphoma. Lymphoblastic lymphoma is treated with intensive, semi-continuous, longer leukemia-derived protocols. Relapses in B-cell and lymphoblastic lymphomas are rare and infrequently curable, even with intensive approaches. Event-free survival rates of approximately 75% have been achieved in anaplastic large-cell lymphomas with various regimens that generally include a short intensive B-like regimen. Immunity seems to play an important role in prognosis and needs further exploration to determine its therapeutic application. ALK inhibitor therapeutic approaches are currently under investigation. For all pediatric lymphomas, the intensity of induction/consolidation therapy correlates with acute toxicities, but because of low cumulative doses of anthracyclines and alkylating agents, minimal or no long-term toxicity is expected. Challenges that remain include defining the value of prognostic factors, such as early response on positron emission tomography/computed tomography and minimal disseminated and residual disease, using new biologic technologies to improve risk stratification, and developing innovative therapies, both in the first-line setting and for relapse.

PMID:
26304908
PMCID:
PMC4979194
DOI:
10.1200/JCO.2014.59.5827
[Indexed for MEDLINE]
Free PMC Article

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