Non-Hodgkin's lymphoma in adolescents: experiences in 378 adolescent NHL patients treated according to pediatric NHL-BFM protocols

• Published in: Leukemia Vol. 25; no. 1; pp. 153 - 160
• Main Authors: Burkhardt, B, Oschlies, I, Klapper, W, Zimmermann, M, Woessmann, W, Meinhardt, A, Landmann, E, Attarbaschi, A, Niggli, F, Schrappe, M, Reiter, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.01.2011; Nature Publishing Group
• Subjects: 631/154/436/108; 692/699/67/1990/291/1621; 692/700/565/1436; Adolescent; Adolescent medicine; Age Factors; Age groups; Biological and medical sciences; Biology; Burkitt Lymphoma - drug therapy; Cancer Research; Care and treatment; Chemotherapy; Children; Critical Care Medicine; Demographic aspects; Diseases; Female; Health aspects; Hematologic and hematopoietic diseases; Hematology; Humans; Intensive; Internal Medicine; Leukemia; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large-Cell, Anaplastic - drug therapy; Lymphoma, Non-Hodgkin - drug therapy; Lymphoma, Non-Hodgkin - mortality; Lymphoma, Non-Hodgkin - pathology; Lymphoma, T-Cell - drug therapy; Male; Medical prognosis; Medical sciences; Medicine; Medicine & Public Health; Non-Hodgkin's lymphomas; Oncology; original-article; Patient outcomes; Pediatrics; Physiological aspects; Prognosis; Teenagers; Young adults; Youth; Germany; United States > US; pediatric protocols; adolescents; non-Hodgkin's lymphoma; Human; Pediatrics; Hematology; Malignant hemopathy; Non Hodgkin lymphoma; Treatment; Lymphoproliferative syndrome; Adolescent; Child; Cancer
• ISSN: 0887-6924; 1476-5551
• DOI: 10.1038/leu.2010.245

Age-related differences in the distribution, biology and treatment response of non-Hodgkin's lymphoma (NHL) in adolescents remain to be elucidated. The current analyses present clinical parameters and outcomes of adolescents treated in pediatric NHL-BFM trials. Patients were stratified by histological subtype: lymphoblastic lymphoma (LBL); mature B-NHL, including Burkitt's lymphoma/leukemia (BL/B-AL), diffuse B-cell lymphoma (DLBCL-CB) and mediastinal B-cell lymphoma (PMLBL); and anaplastic large cell lymphoma (ALCL). Between October 1986 and December 2007, 2915 patients were registered, including 378 (13%) adolescents (15–18 years) with BL/B-AL ( n =101), ALCL ( n =74), DLBCL-CB ( n =55), T-LBL ( n =45), PMLBL ( n =24), pB-LBL ( n =13) and rare or not-specified NHL subtypes ( n =66). The 5-year event-free survival (EFS) was 79±2% for adolescents compared with 85±1% for patients aged <15 years ( P =0.014). EFS was 83±7% for adolescents with T-LBL, 82±4% with BL/B-AL, 85±5% with DLBCL-CB, 57±10% with PMLBL and 70±6% with ALCL. According to sex, the 5-year EFS in females versus males, respectively, was 70±5 versus 83±2% overall ( P =0.004), 57±17 versus 92±6% ( P =0.0036) for T-LBL patients and 71±9 versus 97±3% ( P =0.0067) for DLBCL-CB patients. Adolescents with NHL treated according to pediatric NHL-BFM protocols had an EFS of 79±2%, which is marginally inferior to that of children. In adolescents with T-LBL and DLBCL-CB, female sex was associated with a worse prognosis.