Treatment of Children and Young Adults with Early-Stage Non-Hodgkin's Lymphoma

Abstract

A nine-week chemotherapy regimen without irradiation of the primary sites of involvement is adequate therapy for most children and young adults with early-stage, nonlymphoblastic non-Hodgkin's lymphoma.

Adult Cancer Survivorship: Evolution, Research, and Planning Care

“…It was noted that normal tissues of growing children were especially likely to suffer from the deleterious effects of radiation therapy and certain chemotherapeutic agents, and studies of selected cohorts of survivors continued into the decades of the 1980s and 1990s. [21][22][23][24][25][26][27][28][29][30][31] This led to the recognition that second cancers, cardiac disease, neurocognitive dysfunction, infertility, and other late complications could be attributed to specific therapies. [22][23][24]32 Studies of the late effects of treatment led to clinical trials that tested the efficacy of reducing the offending agent(s) and also led to the elimination or reduction in dose of radiation for Wilms tumor, lymphomas, acute lymphocytic leukemia, and brain tumors.…”

The Societe Francaise d'Oncologie Pediatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia

“…17,21,22 For patients with any stage I and II lymphoma, except for the lymphoblastic type, the Pediatric Oncology Group (POG) recently confirmed that 3 courses of CHOP was as efficient as the same treatment with local radiotherapy or maintenance therapy, yielding an EFS of 89% Ϯ 8%. 21,23 In LMB89, the EFS rate for such stages is 97% (95% CI, 92%-99%). Half of these patients were treated in group B, and it could be contended that some of them were overtreated.…”

Childhood non-Hodgkin’s lymphoma in Cipto Mangunkusumo Hospital, Jakarta: Outcome of treatment 2000-2005

“…1,8 The event-free survival of the patients with LL; a histological subtype that accounts for approximately 15% of NHL in children and young adults-was inferior to that of the patients with other subtypes of lymphomas. 5 Link et al 5 found that only 63% of the patients with early-stage LL were projected to survive without a recurrence of disease for five years, as compared with a projected 89% of patients with small non-cleaved-cell lymphomas and 88% of those with large-cell lymphomas (P<0.001). Advani et al 6 showed that event free survival (EFS) was 48% for LL and 68% for non-LL; while for all patients was 58%.…”

“…These results are consistent with other reported studies. 1,[5][6][7] Clinical presentations of NHL in children are varied and depend on the histological subtype, the extent (or stage) of the disease, and the primary site of tumor. 1 LL typically presents as a mediastinal or head and neck mass.…”