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Large cell non‐Hodgkin lymphoma of childhood
Author(s) -
Mora Jaume,
Filippa Daniel A.,
Thaler Howard T.,
Polyak Tatyana,
Cranor Milicent L.,
Wollner Norma
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(20000101)88:1<186::aid-cncr26>3.0.co;2-5
Subject(s) - cd30 , medicine , large cell lymphoma , lymphoma , anaplastic large cell lymphoma , chop , cd15 , oncology , pathology , cd34 , biology , stem cell , genetics
BACKGROUND The authors report a study of pediatric patients with advanced diffuse large cell lymphoma (DLCL) who were treated with 2 consecutive regimens, LSA2‐L2 and LSA4, over a 25‐year‐period at the Memorial Sloan‐Kettering Cancer Center. They also describe a comparative analysis of two subgroups retrospectively identified as having CD30 positive (+) anaplastic large cell lymphoma (ALCL) and CD30 negative (−) DLCL. To the authors' knowledge, this study represents the longest follow‐up on the largest series of uniformly treated pediatric DLCL patients reported to date. METHODS A total of 78 consecutive patients were treated for Stage III/IV DLCL. Immunophenotypic data were obtained retrospectively for 52 patients using a panel of monoclonal antibodies against CD30, CD15, CD45, CD45Ro, CD43, epithelial membrane antigen, CD5, BCL‐2, cyclin‐D, and p53. RESULTS A disease free survival rate of 72% in patients with advanced stage DLCL using the LSA2‐L2 and LSA4 regimens. Of the 78 treated patients, 56 are alive and without evidence of disease with a median follow‐up of 120 months (range, 24–312 months). The recurrence rate was significantly higher in the CD30+ ALCL subgroup (33%) than in the CD30− DLCL group (0.04%). Of 52 patients for whom immunophenotypic data were available, 28 had disease of B‐cell lineage, 24 had disease of T‐cell/null phenotype, 19 were CD30+ (36.5%), 18 had disease of T‐cell phenotype, and 1 had disease of B‐cell lineage. CONCLUSIONS The CD30− DLCL cases mostly were of B‐cell lineage, had a small risk of treatment failure, and did not develop a recurrence off therapy. A distinct clinical pattern was identified for the CD30+ ALCL group; although these tumors were of T‐cell lineage and had a significantly higher rate of late recurrences (median follow‐up of 24 months) they all were salvageable. Based on the findings of the current study, the authors propose that T‐cell CD30+ ALCL be addressed in the future according to equal dose intensity regimens in induction therapy, as is done for B‐cell lymphomas; prolonged periods of maintenance chemotherapy, as is done for T‐cell lymphoblastic lymphomas; and no central nervous system prophylaxis beyond the induction period unless other recognized risk factors are present. Cancer 2000;88:186–97. © 2000 American Cancer Society.