Treatment Of Pediatric Lymphoma Research Articles

Recent progress in the treatment of pediatric lymphoma in Japan.

Both treatment and prognosis of pediatric non-Hodgkin lymphoma (NHL) have improved dramatically in the last 30 years. Currently, localized or limited-stage NHL (stage I to II) has an approximately 95%-100% 5-year event-free survival (EFS) rate. Furthermore, the prognosis for children with advanced-stage disease (stage III to IV) has doubled from approximately 40% 5-year EFS 30 years ago to more than 80%. Hodgkin lymphoma is also known to have around 80% 10-year EFS rate. These were accomplished not only by the advancement of chemotherapy drugs but also with the global development of organizational frameworks for pediatric clinical study. The Japanese Pediatric Leukemia Lymphoma Study Group is one of such frameworks that was organized in 2003, and it has been playing a great role in Japan ever since. In this study, I described some of the main steps of clinical studies for pediatric lymphoma according to each histologic entity. In the future, however, an effective treatment for refractory or recurrent diseases should be developed. In addition, a precise validation for low-risk patients who need reduced chemotherapy should be performed. Further clarifications on the conditions of patients with rare type lymphoma and an establishment of a standard therapy for them through a collaborative study on a global scale are needed.

Treatment of pediatric lymphoma in Japan: Current status and plans for the future.

Results of pediatric lymphoma treatment have improved markedly over the past 30 years. In Hodgkin's lymphoma, the 5 year event-free survival (EFS) was 81.5% in a retrospective study. In the ALB-NHL03 study, the 5 year EFS according to clinical stage in patients with lymphoblastic T-cell lymphoma (T-LBL) was 70.6% for stage III and 88.9% for stage IV. In mature B-cell lymphoma, the B-NHL03 study indicated that the 4 year EFS according to treatment group was 94% for group 1, 98% for group 2, 84% for group 3, and 78% for group 4. Moreover, the 2 year EFS rate was 81% in Japanese advanced stage patients based on the international ALCL99 study. Thus, EFS >80% was achieved in any subtype of pediatric lymphoma. With regard to refractory or recurrent lymphoma, however, treatment methods for improvement of the survival rate in these patients still need to be developed. Also the difference between child, and adolescent and young adult patients still needs to be clarified, and treatment protocols developed. Although lymphoma treatment does not greatly change according to country, it does differ between other countries and Japan for some subtypes of lymphoma. In particular, the results of treatment of stage III T-LBL in Japan are worse than those in the USA and Europe. The priority in future studies will be to collect data on these differences, and the reasons for these differences.

The utility of FDG PET in diagnosis and follow-up of lymphoma in childhood

Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are among the most common malignancies of childhood. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) can be employed for accurate staging, treatment planning, and response assessment in pediatric patients with lymphomas, taking advantage of the increased FDG uptake of the malignant cells, secondary to their increased metabolic needs. FDG PET has higher sensitivity than other imaging modalities to detect nodular or diffuse lesions and higher sensitivity than bone marrow biopsy to detect bone marrow infiltration. FDG PET consists of an invaluable imaging modality during evaluation and treatment of pediatric lymphomas.

Insight into the biology and treatment of pediatric lymphomas: Clues from international studies

Insight into the biology and treatment of pediatric lymphomas: Clues from international studies

The treatment of pediatric lymphomas: Paradigms to plagiarize?

The excellent results in pediatric lymphomas presented at the Sixth International Conference on Malignant Lymphoma in Lugano encompass several emerging themes and provide paradigms which it may be possible to extrapolate to at least some adult lymphomas. In pediatric Hodgkin's disease, there is mounting evidence that radiation adds nothing except toxicity to effective chemotherapy regimens, with the possible exception that patients with bulky disease, particularly in the mediastinum, may benefit from involved-field radiation. This is of particular importance in view of the recently recognized high rate of late-occurring second solid tumors and cardiac infarction, largely referable to radiotherapy. It is likely that there will be greater efforts to eliminate radiation from treatment protocols wherever possible. In pediatric non-Hodgkin's lymphomas, the intensive regimens used by several cooperative groups in Europe and the United States have resulted in very high event-free survival rates--90% in B-cell lymphomas, and only slightly lower in T-cell lymphomas. These results stand in striking contrast to those obtained in adults with the same diseases, except those treated with the same treatment protocols, who appear to have a similar prognosis. Finally, progress in the characterization of the molecular abnormalities and viral association of pediatric lymphomas is leading to new approaches to diagnosis and the detection of minimal residual disease, as well as to the development of targeted treatment approaches.

New treatment regimens help children with malignant lymphoma

Improved remission rates and long-term disease-free survival in some children with Hodgkin's disease and non-Hodgkin's lymphoma may now be expected. That is the indication, at least, from reports presented by investigators from several cancer centers at the Second International Conference on Malignant Lymphoma, held in Lugano, Switzerland. Only Time Will Tell Although the studies reported at the Lugano conference strongly indicate that extremely high remission rates and apparent long-term survival can be achieved in pediatric patients with lymphomas, using regimens designed to reduce the potential late effects of treatment (leukemia, sterility, and cardiac problems), most participants agree that only time will tell if the new methods really achieve that end. For example, Eli Glatstein, MD, of the National Cancer Institute, Bethesda, Md, said that, in the treatment of pediatric lymphomas, it is still not clear whether the obvious benefits of cure at the present time will be clouded by other

New treatment regimens help children with malignant lymphoma

Improved remission rates and long-term disease-free survival in some children with Hodgkin's disease and non-Hodgkin's lymphoma may now be expected. That is the indication, at least, from reports presented by investigators from several cancer centers at the Second International Conference on Malignant Lymphoma, held in Lugano, Switzerland. <h3>Only Time Will Tell</h3> Although the studies reported at the Lugano conference strongly indicate that extremely high remission rates and apparent long-term survival can be achieved in pediatric patients with lymphomas, using regimens designed to reduce the potential late effects of treatment (leukemia, sterility, and cardiac problems), most participants agree that only time will tell if the new methods really achieve that end. For example, Eli Glatstein, MD, of the National Cancer Institute, Bethesda, Md, said that, in the treatment of pediatric lymphomas, it is still not clear whether the obvious benefits of cure at the present time will be clouded by other