Malignant lymphomas in children. A clinico-pathologic retrospective study. II. Non-Hodgkin's lymphomas.

Abstract

ABSTRACT. Garwicz, S., Landberg, T. and Åkerman, M. (Departments of Paediatrics, Radiotherapy, Cytodiagnostics and Pathology, University Hospital, Lund, Sweden). Malignant lymphomas in children—A clinico‐pathologic retrospective study. II. Non‐Hodgkin's lymphomas. Acta Paediat Scand,63:679, 1974.—Data on 27 children with non‐Hodgkin's lymphomas are given. None had leukemia at the time of diagnosis. Twenty‐one were boys. At microscopic review the lesions were classified according to Rappaport. All but one had diffuse lymphoma, which was lymphocytic in 13, histiocytic in 9, and of the Burkitt‐type in 5. Pronounced differences thus exist between the morphology of non‐Hodgkin's lymphomas in children and in adults. Extralymphatic manifestations were often seen, especially in lymphocytic lymphoma. This type also showed a marked tendency to leukemic transformation, and accounted for 5 out of the 6 patients with leukemic transformation. Such transformation occurred within 6 months after the diagnosis. Treatment consisted of radiation therapy or chemotherapy or a combination of the two. The results of radiation therapy indicate that the Burkitt‐type tumours do not respond well to conventional fractionation. The survival rate in the present series was very poor. Only 3 of the patients are still alive, whereas the remaining 24 have died mean 5 months after the beginning of treatment. Non‐Hodgkin's lymphomas in children differ from non‐Hodgkin's lymphomas in adults. Generalization is the rule, and a more aggressive therapeutic approach is justified, guided by the morphologic picture, and utilizing radiation therapy and combination chemotherapy.