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Autologous peripheral blood stem cell transplantation in children with non-Hodgkin's lymphoma: A report from the Korean society of pediatric hematology-oncology

Cited 22 time in Web of Science Cited 28 time in Scopus

Won, Sung Chul; Han, Jung Woo; Kwon, Seung Yeon; Shin, Hee-Young; Ahn, Hyo-Seop; Hwang, Tae Ju; Yang, Woo Ick; Lyu, Chuhl Joo

Issue Date
Springer Verlag
Ann Hematol. 2006 Nov;85(11):787-94. Epub 2006 Aug 24.
AdolescentChildChild, PreschoolFemaleHumansInfantKoreaLymphoma, Non-Hodgkin/mortality/*therapyMaleRetrospective StudiesSalvage TherapySurvivalSurvival AnalysisTransplantation, AutologousTreatment OutcomePeripheral Blood Stem Cell Transplantation
Recent development of stratified chemotherapeutic regimens has rapidly improved the survival rate of non-Hodgkin's lymphoma (NHL) of childhood. Despite these improvements, the outcome for children with recurrent or refractory NHL remains dismal. We explored the use of high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (HDC/PBSCT) for children with either refractory or recurrent NHL, and we evaluated various factors influencing outcome of HDC/PBSCT. Thirty-three patients underwent HDC/PBSCT in 11 institutes were enrolled. All patients had refractory or recurrent NHL. Sex, stage at diagnosis, histologic subtype (lymphoblastic, Burkitt's, and large-cell lymphoma), LDH level at diagnosis, disease status at transplantation, and preparative regimens for HDC/PBSCT were explored. In regard to the patients, six had Burkitt's lymphoma, 13 had lymphoblastic lymphoma, and 14 had large-cell lymphoma. The 2-year event-free survival (EFS) was 59.1+/-9.3%. The EFS for Burkitt's, lymphoblastic, and large-cell lymphoma was 66.7+/-27.2, 50.5+/-14.8, and 82.1+/-11.7%, respectively. In comparison with lymphoblastic and non-lymphoblastic lymphoma, the relative risk for lymphoblastic lymphoma was higher than the others (P = 0.037). EFS between anaplastic large-cell and diffuse large-cell lymphoma was 100 and 55.6+/-24.9%, respectively (P = 0.106). Status at transplantation was the most predictive factor for the survival after HDC/PBSCT (EFS for CR 70.8+/-9.5% vs non-CR 20.0+/-17.9%, P = 0.008). Transplantation-related complications were minimal, and infection was the most prevalent complication. HDC/PBSCT is considered applicable to recurrent or refractory pediatric NHL patients safely and it could replace conventional chemotherapy. In this study, children with CR status at the time of HDC/PBSCT showed higher survival rate. However, refractory or recurrent lymphoblastic lymphoma patients showed dismal results. Therefore, new therapeutic modalities may be needed for this group of NHL patients.
0939-5555 (Print)
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