Cancer Res Treat.  2020 Apr;52(2):359-368. 10.4143/crt.2019.219.

Clinical Characteristics and Treatment Outcomes of Pediatric Patientswith Non-Hodgkin Lymphoma in East Asia

• Suh JK
• Gao YJ
• Tang JY
• Jou ST
• Lin DT
• Takahashi
• Kojima S
• Jin L
• Zhang Y
• Seo JJ

• KMID: 2500321
• DOI: http://doi.org/10.4143/crt.2019.219

Abstract

Purpose
The presentations and geographic incidence of pediatric non-Hodgkin lymphoma (NHL) differ from those of adults. This study delineated the characteristics and outcomes of pediatric NHL in East Asia.
Materials and Methods
Medical records of 749 pediatric patients with NHL treated at participating institutions in mainland China, Japan, Korea, and Taiwan from January 2008 to December 2013 were reviewed. Demographic and clinical features, survival outcomes, and putative prognostic factors were analyzed.
Results
Five hundred thirty patients (71%) were male. The most common pathologic subtypes were Burkitt lymphoma (BL) (36%). Six hundred seven patients (81%) had advanced diseases at diagnosis. The 5-year overall survival and event-free survival (EFS) rates were 89% and 84%. The 5-year EFS rates of BL, lymphoblastic lymphoma, and diffuse large B-cell lymphoma were 88%, 88%, and 89%, and those of anaplastic large cell lymphoma (ALCL) and peripheral T-cell lymphoma (PTCL) were 71% and 56% (p < 0.001). Central nervous system involvement, high lactate dehydrogenase level (> 250 IU/mL), and advanced disease at diagnosis ( stage III) were associated with poor outcomes (p < 0.05). ALCL and PTCL relapsed more frequently than other pathologic subtypes (p < 0.001).
Conclusion
In East Asia, PTCL was more frequent than in Western countries, and bone marrow involvement did not affect treatment outcome. This international study should motivate future collaborative study on NHL in East Asia.

Keyword

Lymphoma; Child; Treatment outcome; Retrospective studies

Figure

• 

  Fig. 1. Pathologic subtype distribution according to age. BL was the most common subtype in patients under 14 years old (A), while DLBCL was in patients aged 15-20 years old (B). BL, Burkitt lymphoma; LL, lymphoblastic lymphoma; DLBCL, diffuse large B-cell lymphoma; ALCL, anaplastic large cell lymphoma; PTCL, peripheral T-cell lymphoma.

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  Fig. 2. Treatment outcomes of the 749 pediatric patients with NHL (A) and treatment outcomes according to pathologic subtypes (B). OS, overall survival; EFS, event-free survival; CI, confidence interval; BL, Burkitt lymphoma; LL, lymphoblastic lymphoma; DLBCL, diffuse large B-cell lymphoma; ALCL, anaplastic large cell lymphoma; PTCL, peripheral T-cell lymphoma.

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  Fig. 3. Treatment outcomes of patients with relapse according to subtype. Cumulative incidence of relapse (A) and overall survival (B) showed that, anaplastic large cell lymphoma (ALCL) and peripheral T-cell lymphoma (PTCL) had a higher incidence of relapse, but they were salvaged successfully compared to Burkitt lymphoma (BL) and lymphoblastic lymphoma (LL). DLBCL, diffuse large B-cell lymphoma.

Reference

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