The long-term outlook for children treated for non-Hodgkin lymphomas. A report of the Children's Solid Tumour Group.

Twentynine children with non-Hodgkin's lymphomas (NHL) were treated between 1974 and 1977 with a protocol based on those used for childhood ALL. 76% of patients had advanced disease by Ann Arbor criteria. All tumours had Rappaport's diffuse histology. 19 patients (65%) achieved complete remission, 14 (65%) remained alive and disease free beyond 42 months from diagnosis. 10 patients failed to enter complete remission, of whom all died. 7 patients relapsed; 5 died, 2 remain disease free and off treatment at 19 and 29 months. Comparison with a historic group of 20 consecutively treated children shows improved survival (P less than 0.01). 18 controls died. Histology was reviewed using the Kiel classification and staging according to Murphy's criteria. These are compared with the methods used initially. The improved outlook for children with NHL using intensive multiple drug regimes and cranial prophylaxis is confirmed. In staging childhood NHL, Murphy's criteria, which take into account the natural history of the disease, have greater prognosis value. Histology and pattern of outcome of the disease suggest basic differences between primary abdominal and primary mediastinal and nodal disease. This is now being confirmed with immunological typing and will be reflected in the development of future protocols.