Kobayashi Ryoji, Sunami Shosuke, Mitsui Tetsuo, Nakazawa Atsuko, Koga Yuhki, Mori Takeshi, Tanaka Fumiko, Ueyama Jun-ichi, Osumi Tomoo, Fukano Reiji, Ohki Kentaro, Sekimizu Masahiro, Mori Tetsuya
Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan.
Department of Pediatrics, Narita Red Cross Hospital, Narita, Japan.
Pediatr Int. 2015 Aug;57(4):523-34. doi: 10.1111/ped.12725.
Results of pediatric lymphoma treatment have improved markedly over the past 30 years. In Hodgkin's lymphoma, the 5 year event-free survival (EFS) was 81.5% in a retrospective study. In the ALB-NHL03 study, the 5 year EFS according to clinical stage in patients with lymphoblastic T-cell lymphoma (T-LBL) was 70.6% for stage III and 88.9% for stage IV. In mature B-cell lymphoma, the B-NHL03 study indicated that the 4 year EFS according to treatment group was 94% for group 1, 98% for group 2, 84% for group 3, and 78% for group 4. Moreover, the 2 year EFS rate was 81% in Japanese advanced stage patients based on the international ALCL99 study. Thus, EFS >80% was achieved in any subtype of pediatric lymphoma. With regard to refractory or recurrent lymphoma, however, treatment methods for improvement of the survival rate in these patients still need to be developed. Also the difference between child, and adolescent and young adult patients still needs to be clarified, and treatment protocols developed. Although lymphoma treatment does not greatly change according to country, it does differ between other countries and Japan for some subtypes of lymphoma. In particular, the results of treatment of stage III T-LBL in Japan are worse than those in the USA and Europe. The priority in future studies will be to collect data on these differences, and the reasons for these differences.
在过去30年里，儿童淋巴瘤的治疗结果有了显著改善。在霍奇金淋巴瘤方面，一项回顾性研究显示5年无事件生存率（EFS）为81.5%。在ALB - NHL03研究中，淋巴母细胞性T细胞淋巴瘤（T - LBL）患者根据临床分期的5年EFS，III期为70.6%，IV期为88.9%。在成熟B细胞淋巴瘤中，B - NHL03研究表明，根据治疗组划分的4年EFS，第1组为94%，第2组为98%，第3组为84%，第4组为78%。此外，根据国际ALCL99研究，日本晚期患者的2年EFS率为81%。因此，儿童淋巴瘤的任何亚型都实现了EFS>80%。然而，对于难治性或复发性淋巴瘤，仍需开发提高这些患者生存率的治疗方法。此外，儿童与青少年及年轻成人患者之间的差异仍需明确，并制定治疗方案。虽然淋巴瘤治疗在不同国家之间变化不大，但在某些淋巴瘤亚型上，其他国家与日本之间存在差异。特别是，日本III期T - LBL的治疗结果比美国和欧洲更差。未来研究的重点将是收集这些差异的数据以及造成这些差异的原因。
