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Childhood Non-Hodgkin Lymphoma Treatment (Professional) (cont.)

Changes to This Summary (02/03/2012)

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.

Cellular Classification of Childhood Non-Hodgkin Lymphoma (NHL)

Added Oschlies et al. as reference 23.

Added text to state that a subset of pediatric diffuse large B-cell lymphoma (DLBCL) cases were found to have a translocation that juxtaposes the IRF4 oncogene next to one of the immunoglobulin loci. DLBCL cases with an IRF4 translocation were significantly more frequent in children than adults, were germinal center–derived B-cell lymphomas, and were associated with favorable prognosis compared with DLBCL cases lacking this abnormality (cited Salaverria et al. as reference 30.)

Added text to state that in a series of 375 children and adolescents with systemic ALK-positive anaplastic large cell lymphoma (ALCL), the presence of a small cell or lymphohistiocytic component was observed in 32% of patients and was significantly associated with a high risk of failure in the multivariate analysis, controlling for clinical characteristics (cited Lamant et al. as reference 35).

Added text to state that a Japanese study described extranodal NK/T-cell lymphoma, nasal type as the most common peripheral T-cell lymphoma (PTCL) subtype among Japanese children (10 of 21 PTCL cases). In adults, extranodal NK/T-cell lymphoma, nasal type is generally Epstein-Barr virus (EBV)-positive, and 60% of the cases observed in Japanese children were EBV-positive (cited Kobayashi et al. as reference 59).

Low-Stage Childhood NHL Treatment

Added text to state that follicular lymphoma is rare in children, with only case reports and case series to guide therapy. Case series with a variety of chemotherapy approaches have resulted in good outcomes (cited Kumar et al. as reference 14).

Recurrent Childhood NHL Treatment

Added text about how in a retrospective study of relapsed or refractory ALCL in patients who received Berlin-Frankfurt-Muenster–type first-line therapy, reinduction chemotherapy followed by autologous stem cell transplant resulted in 59% 5-year event-free survival and 77% overall survival; however, outcome of patients with bone marrow or central nervous system involvement, relapse during first-line therapy, or CD3-positive ALCL was poor. These patients may benefit from allogeneic transplantation (cited Woessmann et al. as reference 21 and level of evidence 2A).

Added text about how brentuximab vedotin has been evaluated in adults with ALCL in phase I and phase II studies; in a phase I study in adults with CD30-positive cancers, two of two patients with ALCL achieved complete remission (CR), and a phase II trial in adults with relapsed ALCL showed a CR rate of 57% and a partial remission rate of 29%. The number of pediatric patients treated with brentuximab vedotin is not sufficient to determine whether they respond differently than adult patients (cited Younes et al. and Seattle Genetics, Inc. as references 24 and 25, respectively).

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