The role of hematopoietic stem cell transplantation with relapsed or primary refractory childhood B-cell non-Hodgkin lymphoma and mature B-cell leukemia: a retrospective analysis of enrolled cases in Japan.
BACKGROUND
There have been excellent treatment results for children with B-cell non-Hodgkin lymphoma (B-NHL) and mature B-cell leukemia (B-ALL) in the last few decades. However, a small subset of relapsed or refractory patients, after first-line therapy, still have a poor prognosis.


METHODS
Thirty-three patients with relapsed or primary refractory B-NHL/B-ALL among 327 newly diagnosed patients between 1996 and 2004 were analyzed retrospectively.


RESULTS
After salvage therapy, 18 patients were chemotherapy-sensitive and 15 patients suffered from progression. Among 18 patients who had a chemotherapy-sensitive disease, 4 of 5 patients who underwent hematopoietic stem cell transplantation (HSCT) during remission survived without progression, while 3 of 12 patients who did not receive HSCT were alive without disease progression. Fifteen patients never sensitive to salvage therapy died.


CONCLUSIONS
Patients with relapsed/primary refractory B-NHL/B-ALL have a poor prognosis with current treatment approaches, while the patients sensitive to salvage therapy have a respectable chance to achieve a sustained complete second remission with HSCT.
Fujita
Naoto
N
Department of Pediatrics, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima 730-8619, Japan. nfujita@hiroshima-med.jrc.or.jp
Mori
Tetsuya
T
Mitsui
Tetsuo
T
Inada
Hiroko
H
Horibe
Keizo
K
Tsurusawa
Masahito
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D015448:Leukemia, B-Cell / Q000628:therapy*; D016393:Lymphoma, B-Cell / Q000628:therapy*; D008297:Male; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome