Müller Judit, Csóka Mónika, Jakab Zsuzsanna, Ponyi Andrea, Erlaky Hajna, Kovács Gábor
II. sz. Gyermekklinika, Semmelweis Egyetem, Budapest, 1094, Hungary.
Magy Onkol. 2006;50(3):253-9. Epub 2006 Nov 12.
Between 1990 and 2004, 230 children with non-Hodgkin's lymphoma (NHL) were treated according to the Berlin-Frankfurt-Münster (BFM) protocols (NHL-BFM-90 and -95) in Hungary. The aim of the present study was to summarize our experience with these protocols, to assess the survival rates and to compare the Hungarian data with the international results. The male-to-female ratio was 2.59:1, the mean age at the time of diagnosis was 10 years and 1 month. Ninety-one children had lymphoblastic/T-NHL (LB/T-NHL), 108 B-NHL and 31 anaplastic large cell lymphoma (ALCL). Twenty-eight patients had relapse after a mean time of 13 months from the time of the initial diagnosis. In the above mentioned period, 16 children underwent autologous stem-cell transplantation. Nine patients with B-NHL got anti-CD20 immunotherapy. The five-year overall survival (OS) of our patients is 77.8%+/-3%, the event-free survival (EFS) is 75.1%+/-3%. The 5-year OS and EFS rates were not statistically different in the three histology groups (OS: 71.6%+/-5%, 82.7%+/-4% and 80.3%+/-7%; EFS: 68.7%+/-5%, 81.1%+/-4% and 73.9%+/-8% in LB/T-NHL, B-NHL and ALCL, respectively). We can conclude that non-Hodgkin's lymphoma has a quite good prognosis among the malignant pediatric diseases. The cure rate is over 75%. The Hungarian results are comparable with other international data. In the last five years the mortality during induction was reduced from 10% to 2% and the OS is about 10% better than it was before. In case of relapse or residual disease, therapeutic results can be improved with stem-cell transplantation with or without immunotherapy.
1990年至2004年间，匈牙利有230名非霍奇金淋巴瘤（NHL）患儿按照柏林-法兰克福-明斯特（BFM）方案（NHL-BFM-90和-95）接受治疗。本研究的目的是总结我们使用这些方案的经验，评估生存率，并将匈牙利的数据与国际结果进行比较。男女比例为2.59:1，诊断时的平均年龄为10岁零1个月。91名儿童患有淋巴母细胞性/T-NHL（LB/T-NHL），108名患有B-NHL，31名患有间变性大细胞淋巴瘤（ALCL）。28例患者在初次诊断后平均13个月出现复发。在上述期间，16名儿童接受了自体干细胞移植。9名B-NHL患者接受了抗CD20免疫治疗。我们患者的五年总生存率（OS）为77.8%±3%，无事件生存率（EFS）为75.1%±3%。三个组织学组的5年OS和EFS率无统计学差异（LB/T-NHL、B-NHL和ALCL的OS分别为71.6%±5%、82.7%±4%和80.3%±7%；EFS分别为68.7%±5%、81.1%±4%和73.9%±8%）。我们可以得出结论，非霍奇金淋巴瘤在儿童恶性疾病中预后相当好。治愈率超过75%。匈牙利的结果与其他国际数据相当。在过去五年中，诱导期死亡率从10%降至2%，OS比以前提高了约10%。对于复发或残留疾病，通过有或无免疫治疗的干细胞移植可以改善治疗效果。
