Wessels Glynn, Bernard Hesseling Peter
Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, P.O. Box 19063, Tygerberg 7505, South Africa.
Transfus Apher Sci. 2005 Feb;32(1):27-31. doi: 10.1016/j.transci.2004.10.003. Epub 2005 Jan 22.
Hodgkin's disease (HD) in children corresponds to a large degree to HD in adults. Non-Hodgkin's Lymphoma (NHL) in children, however, differs from NHL in adults with respect to the classification, natural history, management and course. For practical reasons clinicians generally classify and treat NHL in children as either B-cell or T-cell disease. Over the past 22 years, the Paediatric Oncology Unit of the Tygerberg Hospital has treated HD with three different regimens. Use of the CLVPP and MOPP/ABVD regimens resulted in late relapses that adversely affected event free survival (EFS). For the last four years HD has been treated according to the regimen suggested by Schellong with good short term survival rates. Lymphoblastic or T-cell NHL is treated with regimens normally used for acute lymphoblastic leukaemia (e.g. BFM protocols) or modified leukaemia treatments for leukaemia-lymphoma syndromes (e.g. LSA2L2). We lately use a modified BFM regimen with a 70% EFS for all stages. Three consecutive regimens have been used to treat B-cell NHL over the past 22 years. The first was a COMP regimen, followed by the LMB-89 and LMB-96 regimens. Although toxicity has increased with the increased intensity of the treatment regimen, EFS has improved from 25% to 87% for all B-cell NHL. The majority of patients had stage III and IV disease. Although the LMB regimens are toxic, the implementation is manageable provided good laboratory back up and supportive facilities are available.
儿童霍奇金淋巴瘤（HD）在很大程度上与成人霍奇金淋巴瘤相似。然而，儿童非霍奇金淋巴瘤（NHL）在分类、自然病史、治疗和病程方面与成人非霍奇金淋巴瘤有所不同。出于实际原因，临床医生通常将儿童NHL分类并治疗为B细胞或T细胞疾病。在过去的22年里，泰格堡医院儿科肿瘤科采用了三种不同的方案治疗HD。使用CLVPP和MOPP/ABVD方案导致晚期复发，对无事件生存期（EFS）产生了不利影响。在过去的四年里，HD一直按照谢隆建议的方案进行治疗，短期生存率良好。淋巴母细胞性或T细胞NHL采用通常用于急性淋巴细胞白血病的方案（如BFM方案）或针对白血病-淋巴瘤综合征的改良白血病治疗方案（如LSA2L2）进行治疗。我们最近使用了一种改良的BFM方案，所有分期的EFS为70%。在过去的22年里，连续使用了三种方案治疗B细胞NHL。第一种是COMP方案，随后是LMB - 89和LMB - 96方案。尽管随着治疗方案强度的增加毒性也增加了，但所有B细胞NHL的EFS已从25%提高到87%。大多数患者患有III期和IV期疾病。尽管LMB方案有毒性，但只要有良好的实验室支持和辅助设施，实施起来是可控的。
