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Risk factors and treatment of childhood and adolescent B urkitt lymphoma/leukaemia
Author(s) -
Miles Rodney R.,
Arnold Staci,
Cairo Mitchell S.
Publication year - 2012
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2011.09024.x
Subject(s) - medicine , lymphoma , vincristine , oncology , prednisone , chemotherapy , cyclophosphamide , lymphoblastic lymphoma , radiation therapy , immunology , burkitt's lymphoma , targeted therapy , pediatrics , cancer , immune system , t cell
Summary B urkitt lymphoma/leukaemia is the most common (40%) form of non‐ H odgkin lymphoma that occurs in children and adolescents. The prognosis of advanced (disseminated) B urkitt lymphoma/leukaemia in children and adolescents three decades ago had a 5‐year event‐free survival ( EFS ) of <40%, and required combination chemotherapy and radiation therapy over a 1–2 year period. Currently, the prognosis for the same advanced stage has a 5‐year EFS of 85–90% with <6 months of chemotherapy only. Radiation therapy has been eliminated for children and adolescents with B urkitt lymphoma/leukaemia except in emergencies, such as superior vena cava syndrome and acute neurological impairment or in patients with relapse/progression. Current risk factors in the prognosis of childhood and adolescent B urkitt lymphoma/leukaemia include: lactate dehydrogenase level ≥ 2× the upper normal limit at diagnosis, bone marrow and central nervous system involvement, poor response to cyclophosphamide, vincristine and prednisone reduction therapy and poor risk cytogenetics. New and novel therapeutic approaches include monoclonal antibody (anti‐ CD 20) therapy, targeted cellular immune therapy and small molecule inhibitors. Future strategies should include improved staging and risk classification, reduction of cytotoxic chemotherapy, the investigation of targeted therapy, an increased understanding of the underlying biology of B urkitt lymphoma/leukaemia, strategies for prevention and approaches to reduce acute and chronic toxicities.