title: Improved treatment results of children with B-cell non-Hodgkin lymphoma: a report from the Japanese Pediatric Leukemia/Lymphoma Study Group B-NHL03 study.
abstract: BACKGROUND
  Previous Japanese studies of childhood B-cell non-Hodgkin lymphoma (B-NHL) have shown a favorable outcome, though the study size was too small to effectively assess the efficacy and safety of treatment for childhood B-NHL.
  
  
  METHODS
  We performed a nation-wide prospective B-NHL03 study to assess the efficacy and safety of short-pulse intensive chemotherapy for children with B-NHL. They were stratified into four treatment groups according to disease stage, tumor resectability and bone marrow/CNS involvement: Group 1 with all resected stage I/II, Group 2 with non-resected stage I/II, Group 3 with stage III & CNS-negative stage IV, and Group 4 with CNS-positive stage IV & Burkitt leukemia. Treatment duration was 2 courses for Group 1, 4 courses for Group 2, and 6 courses for Groups 3 and 4, respectively. CNS irradiation was omitted in all patients.
  
  
  RESULTS
  The follow-up time ranged from 0.8 to 88 months, with a median of being 45 months. For 321 patients analyzed in this study, overall survival and event-free survival (EFS) at 4 years was 92.7% and 87.4%, respectively. The 4-year EFS according to treatment group were 94% for Group 1 (n = 17), 98% for Group 2 (n = 103), 84% for Group 3 (n = 111), and 78% for Group 4 (n = 90). There was no significant difference in outcome by histology. Therapy-related death occurred in three patients in remission.
  
  
  CONCLUSIONS
  Our nationwide large-scale study resulted in a cure rate above 90% with <1% toxic death in childhood B-NHL.
authors: Advanced Medical Research Center, Aichi Medical University, Aichi, Japan.
authors: Masahito
authors: M
authors: Tsurusawa
authors: Tetsuya
authors: T
authors: Mori
authors: Akira
authors: A
authors: Kikuchi
authors: Tetsuo
authors: T
authors: Mitsui
authors: Shosuke
authors: S
authors: Sunami
authors: Ryoji
authors: R
authors: Kobayashi
authors: Tetsuya
authors: T
authors: Takimoto
authors: Akiko
authors: A
authors: Saito
authors: Tomoyuki
authors: T
authors: Watanabe
authors: Junichiro
authors: J
authors: Fujimoto
authors: Atsuko
authors: A
authors: Nakazawa
authors: Kouichi
authors: K
authors: Ohshima
authors: Keizo
authors: K
authors: Horibe
mesh_terms: D000293:Adolescent; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D016393:Lymphoma, B-Cell / Q000401:mortality* / Q000473:pathology* / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
keywords: B-NHL03; JPLSG; childhood; non-Hodgkin lymphoma