title: B-cell lineage confers a favorable outcome among children and adolescents with large-cell lymphoma: a Pediatric Oncology Group study.
abstract: OBJECTIVE
  The goal of this study was to assess the immunophenotype of uniformly treated cases of pediatric large-cell non-Hodgkin's lymphoma (NHL) to determine the prognostic importance of B-cell and T-cell lineages and of CD30 positivity.
  
  
  METHODS
  Sixty-nine patients were analyzed by immunochemistry. All patients were classified histologically, staged in a uniform manner, and treated according to one of two protocols for localized (stage I and II) NHL or advanced (stage III and IV) large-cell NHL. Antibodies included anti-CD45, CD20, CD45Ra, MB-2 (not clustered), CD3, CD45Ro, CD43, CD15, CD30, and CD68. Statistical analysis used the exact conditional chi 2 and Kruskall-Wallace tests for clinical features and the log-rank test to evaluate event-free survival (EFS).
  
  
  RESULTS
  Immunophenotypic results demonstrated 25 B-cell, 23 T-cell, and 21 indeterminate lineage. Twenty-seven patients expressed CD30 (17 T-cell and 10 indeterminate lineage), and of these, 22 showed histology of anaplastic large-cell lymphoma (ALCL). B-cell patients were older (P = .018) and showed more favorable survival than patients with T-cell or indeterminate lineage (96% EFS at 3 years, 96% v 67% and 74%, B v T and indeterminate lineage [P = .027]). B-cell lineage was seen more frequently in limited-stage patients, but was also associated with favorable survival when stratified for stage (P = .036). CD30 expression (P = .96) and ALCL histology (P = .90) did not show significant associations with survival.
  
  
  CONCLUSIONS
  We conclude that among pediatric large-cell lymphomas, B-cell lineage is proportionately less frequent than in adults and CD30 antigen-expressing lymphomas are frequent among patients with T-cell and indeterminate lineage. B-cell phenotype tends to occur in older children and is associated with superior survival.
authors.affiliation: State University of New York Health Science Center, Syracuse, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Hutchison
authors.forename: C W
authors.initials: CW
authors.lastname: Berard
authors.forename: J J
authors.initials: JJ
authors.lastname: Shuster
authors.forename: M P
authors.initials: MP
authors.lastname: Link
authors.forename: T E
authors.initials: TE
authors.lastname: Pick
authors.forename: S B
authors.initials: SB
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002170:Canada; D016009:Chi-Square Distribution; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D017730:Ki-1 Antigen / Q000378:metabolism; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D016399:Lymphoma, T-Cell / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008297:Male; D011379:Prognosis; D012307:Risk Factors; D014481:United States
chemical_list: D017730:Ki-1 Antigen