BACKGROUND: Reliable prognostic factors have not been established for advanced-stage pediatric lymphoblastic lymphoma (LL). We analyzed treatment outcomes and potential risk factors in children and adolescents with advanced-stage LL treated over a 40-year period. PATIENTS AND METHODS: From 1962 through 2002, 146 patients (99 boys and 47 girls) with stage III (n = 111) or stage IV (n = 35) LL were treated at St Jude Children's Research Hospital. The five treatment eras were 1962-1975 (no protocol), 1975-1979 (NHL-75), 1979-1984 (Total 10 High), 1985-1992 (Pediatric Oncology Group protocol), and 1992-2002 (NHL13). Age at diagnosis was <10 years in 65 patients and ≥10 years in 81. RESULTS: Outcomes improved markedly over successive treatment eras. NHL13 produced the highest 5-year event-free survival (EFS) estimate (82.9% ± 6.1% [SE]) compared with only 20.0% ± 8.0% during the earliest era. Treatment era (P < 0.0001) and age at diagnosis (<10 years versus ≥10 years, P = 0.0153) were independent prognostic factors, whereas disease stage, lactate dehydrogenase level, and presence of a pleural effusion were not. CONCLUSIONS: Treatment era and age were the most important prognostic factors for children with advanced-stage LL. We suggest that a better assessment of early treatment response may help to identify patients with drug-resistant disease who require more intensive therapy.
BACKGROUND: Reliable prognostic factors have not been established for advanced-stage pediatric lymphoblastic lymphoma (LL). We analyzed treatment outcomes and potential risk factors in children and adolescents with advanced-stage LL treated over a 40-year period. PATIENTS AND METHODS: From 1962 through 2002, 146 patients (99 boys and 47 girls) with stage III (n = 111) or stage IV (n = 35) LL were treated at St Jude Children's Research Hospital. The five treatment eras were 1962-1975 (no protocol), 1975-1979 (NHL-75), 1979-1984 (Total 10 High), 1985-1992 (Pediatric Oncology Group protocol), and 1992-2002 (NHL13). Age at diagnosis was <10 years in 65 patients and ≥10 years in 81. RESULTS: Outcomes improved markedly over successive treatment eras. NHL13 produced the highest 5-year event-free survival (EFS) estimate (82.9% ± 6.1% [SE]) compared with only 20.0% ± 8.0% during the earliest era. Treatment era (P < 0.0001) and age at diagnosis (<10 years versus ≥10 years, P = 0.0153) were independent prognostic factors, whereas disease stage, lactate dehydrogenase level, and presence of a pleural effusion were not. CONCLUSIONS: Treatment era and age were the most important prognostic factors for children with advanced-stage LL. We suggest that a better assessment of early treatment response may help to identify patients with drug-resistant disease who require more intensive therapy.
Authors: A Reiter; M Schrappe; W D Ludwig; M Tiemann; R Parwaresch; M Zimmermann; E Schirg; G Henze; G Schellong; H Gadner; H Riehm Journal: Blood Date: 2000-01-15 Impact factor: 22.113
Authors: Barbara L Asselin; Meenakshi Devidas; Chenguang Wang; Jeanette Pullen; Michael J Borowitz; Robert Hutchison; Steven E Lipshultz; Bruce M Camitta Journal: Blood Date: 2011-04-07 Impact factor: 22.113
Authors: Elaine Coustan-Smith; Jose Sancho; Michael L Hancock; Bassem I Razzouk; Raul C Ribeiro; Gaston K Rivera; Jeffrey E Rubnitz; John T Sandlund; Ching-Hon Pui; Dario Campana Journal: Blood Date: 2002-10-01 Impact factor: 22.113
Authors: John T Sandlund; Patricia L Harrison; Gaston Rivera; Frederick G Behm; David Head; James Boyett; Jeffrey E Rubnitz; Amar Gajjar; Susana Raimondi; Raul Ribeiro; Melissa Hudson; Mary Relling; William Evans; Ching-Hon Pui Journal: Blood Date: 2002-07-01 Impact factor: 22.113
Authors: Elaine Coustan-Smith; Jose Sancho; Frederick G Behm; Michael L Hancock; Bassem I Razzouk; Raul C Ribeiro; Gaston K Rivera; Jeffrey E Rubnitz; John T Sandlund; Ching-Hon Pui; Dario Campana Journal: Blood Date: 2002-07-01 Impact factor: 22.113
Authors: G V Dahl; G Rivera; C H Pui; J Mirro; J Ochs; D K Kalwinsky; M Abromowitch; A T Look; S B Murphy Journal: Blood Date: 1985-11 Impact factor: 22.113
Authors: E Coustan-Smith; A Gajjar; N Hijiya; B I Razzouk; R C Ribeiro; G K Rivera; J E Rubnitz; J T Sandlund; M Andreansky; M L Hancock; C-H Pui; D Campana Journal: Leukemia Date: 2004-03 Impact factor: 11.528
Authors: Véronique Minard-Colin; Laurence Brugières; Alfred Reiter; Mitchell S Cairo; Thomas G Gross; Wilhelm Woessmann; Birgit Burkhardt; John T Sandlund; Denise Williams; Marta Pillon; Keizo Horibe; Anne Auperin; Marie-Cécile Le Deley; Martin Zimmerman; Sherrie L Perkins; Martine Raphael; Laurence Lamant; Wolfram Klapper; Lara Mussolin; Hélène A Poirel; Elizabeth Macintyre; Christine Damm-Welk; Angelo Rosolen; Catherine Patte Journal: J Clin Oncol Date: 2015-08-24 Impact factor: 44.544