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Childhood Non-Hodgkin Lymphoma Treatment (PDQ®)

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Changes to This Summary (03/05/2015)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Childhood Non-Hodgkin Lymphoma (NHL)

Added Williams et al. as reference 30.

Added text to state that the Berlin-Frankfurt-Munster group reported that in pediatric patients with T-cell lymphoblastic lymphoma, loss of heterozygosity at chromosome 6q was observed in 12% of patients and was associated with unfavorable prognosis. NOTCH1 mutations were seen in 60% of patients and were associated with favorable prognosis; NOTCH1 mutations were rarely seen in patients with loss of heterozygosity in 6q16 (cited Bonn et al. as reference 34).

Cellular Classification of Childhood NHL

Added text to state that one study suggested that for children with stage I disease who had a complete resection, a “watch and wait” approach without chemotherapy may be indicated (cited Attarbaschi et al. as reference 54). Also added text to state that patients with higher-stage disease also had a favorable outcome with low- and intermediate-intensity chemotherapy with 94% event-free survival and 100% overall survival, with a 2-year median follow-up; it appears that BCL2-rearrangement negativity and high proliferative index predict favorable disease.

Added Yoon et al. as reference 65.

Treatment Option Overview

Added Galardy et al. as reference 17.

Added text to state that data support that positron emission tomography identifies more abnormalities than computed tomography scanning, but it is unclear whether this should be used to change therapy (cited Cheng et al. as reference 23).

Low-Stage Childhood NHL Treatment

Added text to state that although outcome is generally very good, treatments range from surgery only to multiagent chemotherapy and even autologous blood or marrow transplant. It appears that for pediatric patients without the BCL2 rearrangement and a high proliferative index, surgical resection with no further treatment is sufficient for completely resected, localized disease. For those with tumors that have the BCL2 rearrangement, treatment like that of adult patients with follicular lymphoma is preferred (cited Attarbaschi et. al. as reference 20).

High-Stage Childhood B-cell NHL Treatment

Revised text to state that a Children's Oncology Group pilot study added rituximab to baseline chemotherapy with FAB/LMB-96 therapy in patients with stage III and stage IV B-cell NHL; compared with chemotherapy-only protocols, toxicity was similar, despite a trend toward higher peak rituximab levels in younger patients (cited Barth et al. as reference 11 and Goldman et al. as reference 12 and level of evidence 3iiiA). Also added text to state that the addition of rituximab to standard chemotherapy is now being tested in a randomized trial.

High-Stage Childhood Lymphoblastic Lymphoma Treatment

Added Termuhlen et al. as reference 8.

High-Stage Childhood Anaplastic Large Cell Lymphoma Treatment

Added text about an international study that reported on central nervous system involvement in systemic childhood anaplastic large cell lymphoma (cited Williams et al. as reference 10).

Recurrent Childhood NHL Treatment

Revised text to state that there are two case reports of adults with anaplastic large cell lymphoma who achieved complete responses to crizotinib, and seven of nine children with anaplastic large cell lymphoma treated on the pediatric phase I study of crizotinib achieved complete responses (cited Mossé et al. as reference 26).

This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.

  • Updated: March 5, 2015