title: Autologous peripheral blood stem cell transplantation in children with non-Hodgkin's lymphoma: A report from the Korean society of pediatric hematology-oncology.
abstract: 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.
authors.affiliation: Department of Pediatrics, School of Medicine, Yonsei University, 134 Sinchon-dong, Seodaemun-gu, Seoul, 120-752, South Korea.
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Won
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Han
authors.forename: Seung Yeon
authors.initials: SY
authors.lastname: Kwon
authors.forename: Hee-Young
authors.initials: HY
authors.lastname: Shin
authors.forename: Hyo-Seop
authors.initials: HS
authors.lastname: Ahn
authors.forename: Tae Ju
authors.initials: TJ
authors.lastname: Hwang
authors.forename: Woo Ick
authors.initials: WI
authors.lastname: Yang
authors.forename: Chuhl Joo
authors.initials: CJ
authors.lastname: Lyu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007723:Korea; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation; D012189:Retrospective Studies; D016879:Salvage Therapy; D013534:Survival; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome