Treatment of non-Hodgkin's lymphoma in childhood

Abstract

Non-Hodgkin's lymphoma (NHL) is a heterogenous group of disorders, and there exists no sharp border particularly between the T-cell lymphoblastic lymphoma and ALL in childhood. Major advance was made in therapy of pediatric NHL more than 16 years ago by Wollner (1974, 1979, 1982) with her introduction of the LSA2 S2 protocol. Disease-free-survival for all her first 58 patients was 70% for longer than 25 months at a median follow-up of 48 months. Relapse is rare after 2 years disease-freedom in NHL. The BFM group concluded in 1986 that approximately 70% of children with NHL can be cured. They introduced a new strategy for BCL and claimed that differential therapy must be used in NHL. Seventy-four of their 95 high risk BCL were in CCR after 3-4 years. T-cell lymphoma were treated as ALL. (Müller-Wehrich, 1986). Trials are going on with newer drugs and with high doses of both methotrexate and cytosine arabinoside. Anyhow, it seems to be a general consensus of opinion that high cure rate is due to aggressive multiagent chemotherapy while the role of radiotherapy is less clear in pediatric NHL. Heterogenicity of the group, lack of standardization in diagnostic work-up, inclusion of adults in some materials, exclusion of BCL in other, makes it difficult to compare the overall therapeutic results of different treatment protocols for pediatric NHL.(ABSTRACT TRUNCATED AT 250 WORDS)