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青少年非霍奇金淋巴瘤和霍奇金淋巴瘤:科学现状

Adolescent non-Hodgkin lymphoma and Hodgkin lymphoma: state of the science.

作者信息

Hochberg Jessica, Waxman Ian M, Kelly Kara M, Morris Erin, Cairo Mitchell S

机构信息

Department of Pediatrics, Columbia University, New York, NY 10032, USA.

出版信息

Br J Haematol. 2009 Jan;144(1):24-40. doi: 10.1111/j.1365-2141.2008.07393.x.

Abstract

Lymphoma is the most common malignancy among adolescents, accounting for >25% of newly diagnosed cancers in the 15-19 year age group. Hodgkin lymphoma (HL) accounts for the majority (two-thirds) of cases, while the remainder of patients have one of four subtypes of non-Hodgkin lymphoma (NHL): diffuse large B-cell lymphoma (DLBCL) including primary mediastinal B-cell lymphoma (PMBL), Burkitt lymphoma (BL), lymphoblastic lymphoma (LL) or anaplastic large cell lymphoma (ALCL). Epidemiology, histology, treatment and outcome differ between HL and NHL, as well as among the various subtypes of NHL. Adolescent lymphoma is particularly interesting because it often shares features with both childhood and adult lymphoma. As medical oncologists and paediatric oncologists often follow divergent treatment plans, disagreements may arise between practitioners as to how best treat the adolescent group. Additional complicating factors associated with the adolescent years, such as lack of insurance, issues pertaining to body image, and concerns about fertility, can also hinder prompt, appropriate medical management. This review details the complexities associated with the diagnosis and treatment of adolescent lymphoma and updates the state of the science, with particular emphasis on epidemiology, diagnosis, and proper management of HL and the various subtypes of NHL.

摘要

淋巴瘤是青少年中最常见的恶性肿瘤,在15至19岁年龄组新诊断的癌症中占比超过25%。霍奇金淋巴瘤(HL)占病例的大多数(三分之二),而其余患者患有非霍奇金淋巴瘤(NHL)的四种亚型之一:弥漫性大B细胞淋巴瘤(DLBCL),包括原发性纵隔B细胞淋巴瘤(PMBL)、伯基特淋巴瘤(BL)、淋巴母细胞淋巴瘤(LL)或间变性大细胞淋巴瘤(ALCL)。HL和NHL之间以及NHL的各种亚型之间在流行病学、组织学、治疗和预后方面存在差异。青少年淋巴瘤特别有趣,因为它常常兼具儿童和成人淋巴瘤的特征。由于医学肿瘤学家和儿科肿瘤学家通常遵循不同的治疗方案,从业者之间可能就如何最好地治疗青少年群体产生分歧。与青少年时期相关的其他复杂因素,如缺乏保险、身体形象问题以及对生育能力的担忧,也会阻碍及时、恰当的医疗管理。本综述详细介绍了与青少年淋巴瘤诊断和治疗相关的复杂性,并更新了科学现状,特别强调HL以及NHL各种亚型的流行病学、诊断和恰当管理。

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