Kobayashi Ryoji, Sekimizu Masahiro
Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital.
Department of Pediatrics, National Hospital Organization Nagoya Medical Center.
Rinsho Ketsueki. 2017;58(8):1053-1059. doi: 10.11406/rinketsu.58.1053.
Since adolescents and young adults (AYAs) with lymphoma began to be treated by pediatric hematologists and hematology physicians, few data have been collected regarding lymphoma in this generation of patients in Japan. We analyzed the number of pediatric hospitals that have treated hematological AYA patients. In half of the pediatric facilities, patients >15 years of age had been treated, and 40% of those facilities treated >1 AYA every year. A past lymphoma study by the Japanese Pediatric Leukemia/Lymphoma Study Group included some AYA patients. However, only the B-NHL03 study analyzed the difference between children and AYAs. In that study, 25 AYAs (7.8%) were treated among all 321 study patients. The 5-year overall survival rates of patients aged <10, 10-14, >14 years, were 88.7%, 87.0%, and 79.3%, respectively. However, this difference was not statistically significant because of the less number of patients. We analyzed data of stem cell transplantation in patients with non-Hodgkin lymphoma (NHL). Of the allogeneic transplant patients, children and AYAs did not significantly differ in treatment results. However, the 5-year transplant-related mortality after autologous transplantation was significantly higher in children than in AYAs. In NHL patients, the survival rate of AYAs after transplantation was not inferior to that of children.
自从淋巴瘤青少年和青年患者开始由儿科血液学家和血液科医生进行治疗以来,日本关于这一代患者淋巴瘤的相关数据收集甚少。我们分析了治疗血液科青少年和青年患者的儿科医院数量。在一半的儿科机构中,15岁以上的患者得到过治疗,其中40%的机构每年治疗超过1名青少年和青年患者。日本儿科白血病/淋巴瘤研究组过去进行的一项淋巴瘤研究纳入了部分青少年和青年患者。然而,只有B-NHL03研究分析了儿童与青少年和青年患者之间的差异。在该研究中,321名研究患者中共有25名青少年和青年患者(7.8%)接受了治疗。年龄<10岁、10-14岁、>14岁患者的5年总生存率分别为88.7%、87.0%和79.3%。然而,由于患者数量较少,这种差异无统计学意义。我们分析了非霍奇金淋巴瘤(NHL)患者的干细胞移植数据。在异基因移植患者中,儿童与青少年和青年患者的治疗结果无显著差异。然而,自体移植后5年的移植相关死亡率儿童显著高于青少年和青年患者。在NHL患者中,青少年和青年患者移植后的生存率并不低于儿童。