Sandlund John T
332 N. Lauderdale, Memphis, TN 38105, USA.
Hematology Am Soc Hematol Educ Program. 2007:297-303. doi: 10.1182/asheducation-2007.1.297.
The SEER (Surveillance, Epidemiology, and End Results) data for the years 1975-1998 show that children with non-Hodgkin lymphoma (NHL) have a better treatment outcome than do adults. Many factors may contribute to this age-related difference. Some factors are related to the patient (e.g., drug distribution and clearance, performance status, compliance, sex) whereas others pertain to tumor histology and biology. The spectrum of NHL subtypes is well known to differ in children and adults. From ages 5 through 14 years, Burkitt lymphoma is the predominant histologic subtype, whereas diffuse large B-cell lymphoma is most common in the 15- to 29-year age range. Because different treatment strategies are often used in children and adults with NHL, the choice of therapy for adolescents and young adults (ages 15 through 29 years) is challenging and somewhat controversial. It is reasonable to consider pediatric strategies for some adolescents and very young adults with NHL, and pediatric strategies are currently used to treat adults with certain subtypes of NHL (Burkitt lymphoma, lymphoblastic lymphoma). However, the use of pediatric strategies in adults does not guarantee a comparable outcome, as illustrated by trials for adult lymphoblastic lymphoma. There is clearly a need for further biologic study of NHL in children, adolescents, and young adults. Age-related differences in tumor biology have been demonstrated in anaplastic large-cell lymphoma (ALCL) and diffuse large B-cell lymphoma (DLBCL). Additional biologic data will not only improve prognosis and treatment stratification but, more important, will lead to the identification of specific molecular targets for therapy.
1975 - 1998年的监测、流行病学和最终结果（SEER）数据显示，非霍奇金淋巴瘤（NHL）患儿的治疗结果优于成人。许多因素可能导致这种与年龄相关的差异。一些因素与患者有关（例如，药物分布和清除、身体状况、依从性、性别），而其他因素则与肿瘤组织学和生物学有关。众所周知，NHL亚型的谱在儿童和成人中有所不同。在5至14岁年龄段，伯基特淋巴瘤是主要的组织学亚型，而弥漫性大B细胞淋巴瘤在15至29岁年龄范围内最为常见。由于儿童和成人NHL患者通常采用不同的治疗策略，因此为青少年和青年成人（15至29岁）选择治疗方法具有挑战性且存在一定争议。对于一些患有NHL的青少年和非常年轻的成人，考虑采用儿科治疗策略是合理的，目前儿科治疗策略也用于治疗某些NHL亚型（伯基特淋巴瘤、淋巴母细胞淋巴瘤）的成人患者。然而，正如成人淋巴细胞淋巴瘤试验所示，在成人中使用儿科治疗策略并不能保证取得可比的结果。显然需要对儿童、青少年和青年成人的NHL进行进一步的生物学研究。在间变性大细胞淋巴瘤（ALCL）和弥漫性大B细胞淋巴瘤（DLBCL）中已证实肿瘤生物学存在与年龄相关的差异。更多的生物学数据不仅将改善预后和治疗分层，更重要的是，将有助于确定特定的治疗分子靶点。
