Bradley M B, Cairo M S
Department of Pediatrics, Columbia University, New York, NY 10032, USA.
Bone Marrow Transplant. 2008 Jan;41(2):149-58. doi: 10.1038/sj.bmt.1705948. Epub 2007 Dec 17.
Lymphoma is the third most common cancer in children < or =15 years of age. The prognosis for children with newly diagnosed chemosensitive non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) has improved significantly. However, in children with relapsed and refractory NHL, the prognosis is not as promising and the best treatment approach for this poor risk group continues to be a challenge. Between 25 and 30% of patients with advanced stage HD still relapse and in subsets of this group, the outcome is dismal. Aggressive chemotherapy followed by autologous bone marrow transplantation has been used with some improvement in survival. Some centers have investigated allogeneic stem cell transplantation in pediatric patients with recurrent/relapsed lymphoma. There is little consistency in therapeutic approaches and there is no formal recommendation on the best approach for this poor prognostic subgroup. We illustrate the reported pediatric experience of transplantation for lymphoma and discuss how the results from these trials are influencing how we approach the treatment in certain subgroups of pediatric patients with relapsed/refractory lymphoma.
淋巴瘤是15岁及以下儿童中第三大常见癌症。新诊断的化疗敏感型非霍奇金淋巴瘤（NHL）和霍奇金病（HD）患儿的预后有了显著改善。然而，复发难治性NHL患儿的预后并不乐观，针对这一高危群体的最佳治疗方法仍然是一个挑战。25%至30%的晚期HD患者仍会复发，在该组的某些亚组中，预后很差。积极化疗后进行自体骨髓移植已使生存率有所提高。一些中心对复发性/难治性淋巴瘤患儿进行了异基因干细胞移植研究。治疗方法缺乏一致性，对于这一预后不良亚组的最佳治疗方法也没有正式的推荐。我们阐述了已报道的儿童淋巴瘤移植经验，并讨论了这些试验的结果如何影响我们对某些复发/难治性淋巴瘤患儿亚组的治疗方法。
