The impact of age and gender on biology, clinical features and treatment outcome of non‐Hodgkin lymphoma in childhood and adolescence

Abstract

Summary We analysed the impact of age and gender on biology and outcome of 2084 patients diagnosed with non‐Hodgkin lymphoma (NHL) between October 1986 and December 2002 and treated according to the Berlin‐Frankfurt‐Münster (BFM) multicentre protocols NHL‐BFM‐86, ‐90 and ‐95. Median age at diagnosis was 8·0 years for 97 precursor B‐lymphoblastic lymphoma (pB‐LBL) patients, 8·8 years for 335 T‐lymphoblastic lymphoma (T‐LBL) patients, 8·4 years for 1004 Burkitt's lymphoma/leukaemia (BL/B‐AL) patients, 11·4 years for 173 diffuse large B‐cell lymphoma (centroblastic subtype) (DLBCL‐CB) patients, 13·2 years for 40 primary mediastinal large B‐cell lymphoma (PMLBL) patients and 10·8 years for 215 anaplastic large‐cell lymphoma (ALCL) patients (P < 0·00001). The male:female ratio was 0·9:1 for pB‐LBL and PMLBL, 1·7:1 for DLBCL‐CB, 1·8:1 for ALCL, 2·5:1 for T‐LBL and 4·5:1 for BL/B‐AL (P < 0·00001). The probability of event‐free survival at 5 years (5‐year pEFS) was 85 ± 1% for all 2084 patients [median follow‐up 5·7 (0·1–15·9) years], and was significantly superior for male T‐LBL and DLBCL‐CB patients. Comparing age‐groups 0–4, 5–9, 10–14 and 15–18 years, pEFS was inferior for the youngest patients only in the pB‐LBL‐ and ALCL‐groups. T‐LBL and DLBCL‐CB adolescent females had worse outcome than younger girls while age had no impact on pEFS for boys. We conclude that the distribution of age and gender differed between NHL‐subtypes. The impact of gender on outcome differed between NHL subgroups. The prognostic impact of age differed not only by NHL‐subtype but also according to gender in some subtypes.

Fine Needle Aspiration Cytopathology of Pediatric Lympha denopathy among Sudanese Children

“…similar to several studies reported that lymphomas constitute about 10-12% of all malignancies in pediatric patients (Birch and Alston, 2003;Chiu and Weisenburger, 2003;Heerema et al, 2005). About 7-10% are nonHodgkin lymphomas (NHLs), and 4-7% are Hodgkin lymphomas (HLs) (Clarke and Glaser, 2002;Birch and Alston, 2003;Burkhardt et al, 2005).…”

Disease patterns of pediatric non-Hodgkin lymphoma: A study from a developing area in Egypt

“…BL was the most common NHL subtype (69%) in our series. Furthermore, BL accounted for 78.2, 77.2, 68, 48.2, 42.2 and 39% of the cases in studies conducted in Brazil, Kuwait, Saudi Arabia, Germany, UK and Egypt, respectively (16,(21)(22)(23)(24)(25). By contrast, BL was encountered at a surprisingly low frequency (9-12%) in India, Pakistan and Shanghai (21,26).…”

Outcome of children and adolescents with lymphoblastic lymphoma

“…23 Patients with pB-LBL were younger than those with T-LBL, as reported by others. 15,24 However, the median age at diagnosis for our patients with T-LBL was a little higher than reported before (around 8.8 years old). 24 As also reported in previous studies, there was a clear predominance of males (2:1).…”

“…The worst outcome of girls compared with boys observed only in patients older than 9 years has given rise to the hypothesis that advanced pubertal changes in girls compared with boys might contribute to inferior treatment results for females with increasing age. 24 In general, the outcome is inferior for CNS positive as compared with CNS-negative patients, although not for all NHL subgroups. CNS involvement occurs more frequently in patients with advanced disease.…”