Non-Hodgkin's lymphoma in adolescents: Experiences in 378 adolescent NHL patients treated according to pediatric NHL-BFM protocols

Abstract

Age-related differences in the distribution, biology and treatment response of non-Hodgkin's lymphoma (NHL) in adolescents remain to be elucidated. The current analyses present clinical parameters and outcomes of adolescents treated in pediatric NHL-BFM trials. Patients were stratified by histological subtype: lymphoblastic lymphoma (LBL); mature B-NHL, including Burkitt's lymphoma/leukemia (BL/B-AL), diffuse B-cell lymphoma (DLBCL-CB) and mediastinal B-cell lymphoma (PMLBL); and anaplastic large cell lymphoma (ALCL). Between October 1986 and December 2007, 2915 patients were registered, including 378 (13%) adolescents (15-18 years) with BL/B-AL (n101), ALCL (n74), DLBCL-CB (n55), T-LBL (n45), PMLBL (n24), pB-LBL (n13) and rare or not-specified NHL subtypes (n66). The 5-year event-free survival (EFS) was 792% for adolescents compared with 851% for patients aged 15 years (P0.014). EFS was 837% for adolescents with T-LBL, 824% with BL/B-AL, 855% with DLBCL-CB, 5710% with PMLBL and 706% with ALCL. According to sex, the 5-year EFS in females versus males, respectively, was 705 versus 832% overall (P0.004), 5717 versus 926% (P0.0036) for T-LBL patients and 719 versus 973% (P0.0067) for DLBCL-CB patients. Adolescents with NHL treated according to pediatric NHL-BFM protocols had an EFS of 792%, which is marginally inferior to that of children. In adolescents with T-LBL and DLBCL-CB, female sex was associated with a worse prognosis. © 2011 Macmillan Publishers Limited All rights reserved.