title: Treatment of pediatric lymphoma in Japan: Current status and plans for the future.
abstract: Results of pediatric lymphoma treatment have improved markedly over the past 30 years. In Hodgkin's lymphoma, the 5 year event-free survival (EFS) was 81.5% in a retrospective study. In the ALB-NHL03 study, the 5 year EFS according to clinical stage in patients with lymphoblastic T-cell lymphoma (T-LBL) was 70.6% for stage III and 88.9% for stage IV. In mature B-cell lymphoma, the B-NHL03 study indicated that the 4 year EFS according to treatment group was 94% for group 1, 98% for group 2, 84% for group 3, and 78% for group 4. Moreover, the 2 year EFS rate was 81% in Japanese advanced stage patients based on the international ALCL99 study. Thus, EFS >80% was achieved in any subtype of pediatric lymphoma. With regard to refractory or recurrent lymphoma, however, treatment methods for improvement of the survival rate in these patients still need to be developed. Also the difference between child, and adolescent and young adult patients still needs to be clarified, and treatment protocols developed. Although lymphoma treatment does not greatly change according to country, it does differ between other countries and Japan for some subtypes of lymphoma. In particular, the results of treatment of stage III T-LBL in Japan are worse than those in the USA and Europe. The priority in future studies will be to collect data on these differences, and the reasons for these differences.
authors.affiliation: Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Department of Pediatrics, Narita Red Cross Hospital, Narita, Japan.
authors.forename: Shosuke
authors.initials: S
authors.lastname: Sunami
authors.affiliation: Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Mitsui
authors.affiliation: Department of Pathology, Children's Cancer Cente, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakazawa
authors.affiliation: Department of Pediatrics, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Yuhki
authors.initials: Y
authors.lastname: Koga
authors.affiliation: Department of Pediatrics, Kobe University School of Medicine, Kobe, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Pediatrics, Saiseikai Yokohamashi Nanbu Hospital, Yokohama, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Tanaka
authors.affiliation: Department of Multidisciplinary Internal Medicine, Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Ueyama
authors.affiliation: Division of Leukemia and Lymphoma, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Osumi
authors.affiliation: Department of Pediatrics, National Hospital Organization Kyusyu Cancer Center, Fukuoka, Japan.
authors.forename: Reiji
authors.initials: R
authors.lastname: Fukano
authors.affiliation: Department of Hematology and Oncology, Gunma Children's Medical Center, Shibukawa, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ohki
authors.affiliation: Department of Pediatrics, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sekimizu
authors.affiliation: Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mori
mesh_terms: D002648:Child; D003131:Combined Modality Therapy; D005544:Forecasting; D006285:Health Planning / Q000639:trends*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008223:Lymphoma / Q000453:epidemiology / Q000628:therapy*; D009017:Morbidity / Q000639:trends
keywords: adolescent and young adult; childhood; lymphoma