Cancers (Apr 2021)
Treatment and Outcome Analysis of 639 Relapsed Non-Hodgkin Lymphomas in Children and Adolescents and Resulting Treatment Recommendations
- Birgit Burkhardt,
- Mary Taj,
- Nathalie Garnier,
- Veronique Minard-Colin,
- Volkan Hazar,
- Karin Mellgren,
- Tomoo Osumi,
- Alina Fedorova,
- Natalia Myakova,
- Jaime Verdu-Amoros,
- Mara Andres,
- Edita Kabickova,
- Andishe Attarbaschi,
- Alan Kwok Shing Chiang,
- Eva Bubanska,
- Svetlana Donska,
- Lisa Lyngsie Hjalgrim,
- Jacek Wachowiak,
- Anna Pieczonka,
- Anne Uyttebroeck,
- Jelena Lazic,
- Jan Loeffen,
- Jochen Buechner,
- Felix Niggli,
- Monika Csoka,
- Gergely Krivan,
- Julia Palma,
- G. A. Amos Burke,
- Auke Beishuizen,
- Kristin Koeppen,
- Stephanie Mueller,
- Heidi Herbrueggen,
- Wilhelm Woessmann,
- Martin Zimmermann,
- Adriana Balduzzi,
- Marta Pillon
Affiliations
- Birgit Burkhardt
- Department of Pediatric Hematology, Oncology and BMT, University Hospital Muenster, 48149 Münster, Germany
- Mary Taj
- Department of Pediatric Oncology, Royal Marsden Hospital, Surrey SM2 5PT, UK
- Nathalie Garnier
- Hospices Civils de Lyon, Institute of Pediatric Hematology and Oncology, 69002 Lyon, France
- Veronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, Gustave Roussy, Université Paris-Saclay, 94805 Villejuif, France
- Volkan Hazar
- Memorial Healthcare Group Private Antalya Yildiz Hospital, Pediatric Oncology Unit, Antalya 07070, Turkey
- Karin Mellgren
- Department of Pediatric Oncology and Hematology, Sahlgrenska University Hospital, The Queen Silvia Children’s Hospital, 41685 Gothenburg, Sweden
- Tomoo Osumi
- Children’s Cancer Centre, National Centre for Child Health and Development, Tokyo 104-0045, Japan
- Alina Fedorova
- Belarusian Research Centre for Pediatric Oncology, Hematology and Immunology, Research Department, 223053 Minsk, Belarus
- Natalia Myakova
- National Research Centre for Pediatric Hematology, Oncology and Immunology, 129090 Moscow, Russia
- Jaime Verdu-Amoros
- Department of Pediatric Hematology and Oncology, University Hospital Valencia, 46010 Valencia, Spain
- Mara Andres
- Department of Pediatric Oncology, University Hospital Le Fe, 46026 Valencia, Spain
- Edita Kabickova
- Department of Pediatric Hematology and Oncology, Charles University & University Hospital Motol, 150 06 Prague, Czech Republic
- Andishe Attarbaschi
- St. Anna Children’s Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, 1090 Vienna, Austria
- Alan Kwok Shing Chiang
- Department of Pediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
- Eva Bubanska
- Clinic of Pediatric Oncology and Hematology, Slovak Health University and Children’s Faculty Hospital, 97409 Banská Bystrica, Slovakia
- Svetlana Donska
- Centre of Pediatric OncoHematology and BMT, National Ukrainian Children’s Hospital Ochmatdyt, 04070 Kiev, Ukraine
- Lisa Lyngsie Hjalgrim
- Department of Pediatrics and Adolescent Medicine, 2100 Copenhagen, Denmark
- Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60572 Poznan, Poland
- Anna Pieczonka
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60572 Poznan, Poland
- Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospital Leuven, KU Leuven, 3000 Leuven, Belgium
- Jelena Lazic
- Department for Hematology and Oncology, University Children’s Hospital, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Jan Loeffen
- Princess Máxima Centre for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Jochen Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, 0424 Oslo, Norway
- Felix Niggli
- Department of Pediatric Oncology, University Children’s Hospital Zurich, 8032 Zürich, Switzerland
- Monika Csoka
- 2nd Department of Pediatrics, Semmelweis University, 1085 Budapest, Hungary
- Gergely Krivan
- Central Hospital of Southern Pest—National Institute of Hematology and Infectious Diseases, Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, 1097 Budapest, Hungary
- Julia Palma
- Faculty of Medicine, Hospital Luis Calvo Mackenna, Department of Pediatrics—Bone Marrow Transplantation Unit, University of Chile, Santiago 8820808, Chile
- G. A. Amos Burke
- Department of Pediatric Haematology and Oncology and Palliative Care, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Auke Beishuizen
- Princess Máxima Centre for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Kristin Koeppen
- Department of Pediatric Hematology, Oncology and BMT, University Hospital Muenster, 48149 Münster, Germany
- Stephanie Mueller
- Department of Pediatric Hematology, Oncology and BMT, University Hospital Muenster, 48149 Münster, Germany
- Heidi Herbrueggen
- Department of Pediatric Hematology, Oncology and BMT, University Hospital Muenster, 48149 Münster, Germany
- Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
- Martin Zimmermann
- Hannover Medical School, Department of Pediatric Hematology and Oncology, 30625 Hannover, Germany
- Adriana Balduzzi
- Pediatric Hematology and Oncology, Clinica Pediatrica Università degli Studi di Milano Bicocca, Fondazione MBBM, Ospedale San Gerardo, 20126 Monza, Italy
- Marta Pillon
- Department of Child and Woman Health, Oncology Hematology Division, University-Hospital of Padua, 35125 Padua, Italy
- DOI
- https://doi.org/10.3390/cancers13092075
- Journal volume & issue
-
Vol. 13,
no. 9
p. 2075
Abstract
Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r/r NHL). The current project aimed to collect international experience on the re-induction treatment of r/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recommendations. Inclusion criteria were (i) refractory disease, disease progression or relapse of any NHL subtype except anaplastic large cell lymphoma, (ii) age < 18 years at initial diagnosis, (iii) diagnosis in/after January 2000. Data from 639 eligible patients were evaluable. The eight-year probability of overall survival was 34 ± 2% with highly significant differences according to NHL subtypes: 28 ± 3% for 254 Burkitt lymphoma/leukemia, 50 ± 6% for 98 diffuse large B-cell lymphomas, 57 ± 8% for 41 primary mediastinal large B-cell lymphomas, 27 ± 3% for 177 T-lymphoblastic lymphomas, 52 ± 10% for 34 precursor-B-cell lymphoblastic lymphomas and 30 ± 9% for 35 patients with rare NHL subtypes. Subtype-specific factors associated with survival and treatment recommendations are suggested. There were no survivors without HSCT, except in few very small subgroups. Conclusions: There is an urgent need to further improve survival in r/r NHL. The current study provides the largest real-world series, which underlines the role of HSCT and suggests treatment recommendations.
Keywords