Department of Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA.
Br J Haematol. 2012 Mar;156(6):761-5. doi: 10.1111/j.1365-2141.2012.09026.x. Epub 2012 Feb 1.
The refinements in both the staging and response evaluation of children with Burkitt lymphoma (BL) have contributed to the improvements in treatment outcome observed over the past 40 years. Ziegler and Magrath designed a staging system in the 1970s for children with BL in equatorial Africa. Currently, the most widely used staging system around the world is that described by Murphy in 1980, which was developed for children with non-Hodgkin lymphoma (NHL) of any histology. There are opportunities for refinement in this system, particularly with respect to certain extra-nodal sites, such as skin and bone. The findings obtained at diagnosis with novel technologies (functional imaging [e.g., positron emission tomography [PET]] and minimal residual disease [MRD] technology), which are more sensitive with respect to disease detection than historic modalities, also need to be considered. Technological advances have also had impact on the assessment of response evaluation. Standard x-rays were routinely used in the 1960s; nuclear imaging became widely used in the 1970s; computerized axial tomography was incorporated in the 1980s; PET imaging was incorporated and, in many cases, has replaced gallium/bone scans since 2000; and MRD technology has been explored in some of the most recent clinical trials. There is clearly a need for more clinical data on the use of PET and MRD technology in the determination of response evaluation of children with BL as well as other histological subtypes of NHL. An international working group is currently addressing the refinement of both disease staging and response evaluation in children with NHL.
在过去的 40 年中，伯基特淋巴瘤（BL）患儿的分期和反应评估的改进，促成了治疗效果的改善。Ziegler 和 Magrath 于 20 世纪 70 年代为赤道非洲的 BL 患儿设计了分期系统。目前，全球使用最广泛的分期系统是 Murphy 在 1980 年描述的，适用于任何组织学类型的非霍奇金淋巴瘤（NHL）患儿。该系统存在改进的空间，特别是在某些结外部位，如皮肤和骨骼。在使用新技术（功能成像[例如正电子发射断层扫描（PET）]和微小残留病（MRD）技术）诊断时，也需要考虑到新的发现，这些发现比传统方法更敏感。技术进步也对反应评估的评估产生了影响。20 世纪 60 年代常规使用标准 X 射线；20 世纪 70 年代核成像广泛应用；20 世纪 80 年代纳入计算机轴向断层扫描；自 2000 年以来，PET 成像已被纳入，并且在许多情况下已取代镓/骨扫描；MRD 技术已在最近的一些临床试验中进行了探索。显然，需要更多关于 PET 和 MRD 技术在确定 BL 以及 NHL 其他组织学亚型患儿反应评估中的应用的临床数据。一个国际工作组目前正在解决 NHL 患儿疾病分期和反应评估的改进问题。
