Prognostic factors in childhood anaplastic large cell lymphoma: results of a large European intergroup study.

To study prognostic factors of progression/relapse, data concerning 225 children enrolled between 1987 and 1997 in Berlin-Frankfurt-Münster, Société Française d'Oncologie Pédiatrique and United Kingdom Children's Cancer Study Group prospective studies for the treatment of anaplastic large cell lymphoma (ALCL) were merged. Median follow-up was 9.3 years. Five-year overall survival and event-free survival of the whole population was 81% (95% confidence interval, 76%-86%) and 69% (63%-74%), respectively. B symptoms, mediastinal involvement, skin lesions, visceral involvement, St Jude stage 3-4, Ann Arbor stage 3-4, and elevated lactate dehydrogenase increased the risk of progression/relapse in the univariate analysis. In the multivariate analysis, 3 factors remained significant: mediastinal involvement (relative risk [RR] = 2.1 [1.2-3.5]), visceral involvement defined as lung, liver, or spleen involvement (RR = 2.1 [1.3-3.6]), and skin lesions (RR = 1.9 [1.1-3.2]). Five-year progression-free survival (PFS) of the 81 patients with none of these risk factors was 89% [82%-96%], contrasting with a 5-year PFS of 61% [53%-69%] in the 144 patients with at least 1 risk factor (RR = 4.4 [2.2-8.9; P < .001). In conclusion, 3 factors associated with an increased risk of failure in childhood ALCL have been defined: mediastinal involvement, visceral involvement, and skin lesions.

[1]  B. Morland,et al.  Anaplastic large cell lymphoma of bone—is it a bad tumor? , 2007, Pediatric blood & cancer.

[2]  L. Brugières,et al.  Prognostic Factors in Childhood Anaplastic Large Cell Lymphoma (ALCL): Results of the European Intergroup Study. , 2006 .

[3]  M. Pillon,et al.  Anaplastic large cell lymphoma treated with a leukemia‐like therapy , 2005, Cancer.

[4]  N. Tarbell,et al.  Advanced-stage large-cell lymphoma in children and adolescents: results of a randomized trial incorporating intermediate-dose methotrexate and high-dose cytarabine in the maintenance phase of the APO regimen: a Pediatric Oncology Group phase III trial. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  L. Meltesen,et al.  Assessment of t(2;5)(p23;q35) translocation and variants in pediatric ALK+ anaplastic large cell lymphoma. , 2004, American journal of clinical pathology.

[6]  H. Shimada,et al.  Anaplastic large cell lymphoma in Japanese children: retrospective analysis of 34 patients diagnosed at the National Research Institute for Child Health and Development , 2003, British journal of haematology.

[7]  C. R. Pinkerton,et al.  Anaplastic large cell lymphoma in childhood: analysis of 72 patients treated on The United Kingdom Children's Cancer Study Group chemotherapy regimens , 2002, British journal of haematology.

[8]  R. McCuskey,et al.  Iron-Deficient Erythropoiesis in Neonatal Rats , 2002, Neonatology.

[9]  M. Massimino,et al.  Prognostic significance of p80 and visceral involvement in childhood CD30 anaplastic large cell lymphoma (ALCL). , 2001, Medical and pediatric oncology.

[10]  M. Tiemann,et al.  Short-pulse B-non-Hodgkin lymphoma-type chemotherapy is efficacious treatment for pediatric anaplastic large cell lymphoma: a report of the Berlin-Frankfurt-Münster Group Trial NHL-BFM 90. , 2001, Blood.

[11]  S. Pileri,et al.  ALK+ lymphoma: clinico-pathological findings and outcome. , 1999, Blood.

[12]  G. Leverger,et al.  Anaplastic Large-Cell Lymphoma in Children : Analysis of 82 Patients Enrolled in Two Consecutive Studies of the French Society of Pediatric Oncology , 1998 .

[13]  S. Pileri,et al.  ALK expression defines a distinct group of T/null lymphomas ("ALK lymphomas") with a wide morphological spectrum. , 1998, The American journal of pathology.

[14]  S. Pileri,et al.  ALK-positive lymphoma: a single disease with a broad spectrum of morphology. , 1998, Blood.

[15]  P. Gaulard,et al.  Primary anaplastic large-cell lymphoma in adults: clinical presentation, immunophenotype, and outcome. , 1997, Blood.

[16]  K. Pulford,et al.  Detection of anaplastic lymphoma kinase (ALK) and nucleolar protein nucleophosmin (NPM)-ALK proteins in normal and neoplastic cells with the monoclonal antibody ALK1. , 1997, Blood.

[17]  D. Wright,et al.  Childhood non-Hodgkin lymphomas in the United Kingdom: findings from the UK Children's Cancer Study Group. , 1997, Journal of clinical pathology.

[18]  M Schemper,et al.  A note on quantifying follow-up in studies of failure time. , 1996, Controlled clinical trials.

[19]  M. Massimino,et al.  Ki-1 (CD30) anaplastic large-cell lymphoma in children. , 1995, Annals of oncology : official journal of the European Society for Medical Oncology.

[20]  H Stein,et al.  A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. , 1994, Blood.

[21]  M. Tiemann,et al.  Successful treatment strategy for Ki-1 anaplastic large-cell lymphoma of childhood: a prospective analysis of 62 patients enrolled in three consecutive Berlin-Frankfurt-Munster group studies. , 1994, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  S. Raimondi,et al.  Clinical features and treatment outcome for children with CD30+ large-cell non-Hodgkin's lymphoma. , 1994, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[23]  Emili Montserrat,et al.  A predictive model for aggressive non-Hodgkin's lymphoma. , 1993, The New England journal of medicine.

[24]  F. Berger,et al.  A translocation involving a specific breakpoint (q35) on chromosome 5 is characteristic of anaplastic large cell lymphoma (‘Ki‐1 lymphoma') , 1989, British journal of haematology.

[25]  M. Fitzgerald,et al.  HYPERALGESIA IN PREMATURE INFANTS , 1988, The Lancet.

[26]  K. Lennert,et al.  Updated Kiel classification for lymphomas , 1989, The Journal of pathology.

[27]  Murphy Sb.  Classification, staging and end results of treatment of childhood non-Hodgkin's lymphomas: dissimilarities from lymphomas in adults. , 1980 .

[28]  M Tubiana,et al.  Report of the Committee on Hodgkin's Disease Staging Classification. , 1971, Cancer research.

[29]  E. Berg,et al.  World Health Organization Classification of Tumours , 2002 .

[30]  H. Thaler,et al.  Large cell non‐Hodgkin lymphoma of childhood , 2000, Cancer.

[31]  A. Bernheim,et al.  High incidence of the t(2;5)(p23;q35) translocation in anaplastic large cell lymphoma and its lack of detection in Hodgkin's disease. Comparison of cytogenetic analysis, reverse transcriptase-polymerase chain reaction, and P-80 immunostaining. , 1996, Blood.

[32]  P. Rochaix,et al.  Childhood anaplastic large cell lymphoma Ki-1/CD30: clinicopathologic features of 19 cases. , 1994, Medical and pediatric oncology.

[33]  S. Pileri,et al.  Anaplastic large cell lymphoma (Ki-1+/CD30+) in childhood. , 1993, Medical and pediatric oncology.

[34]  M. Paulli,et al.  Adult Ki-1-positive large cell anaplastic lymphoma presenting with skin lesions. , 1989, Acta haematologica.

[35]  S. Murphy.  Classification, staging and end results of treatment of childhood non-Hodgkin's lymphomas: dissimilarities from lymphomas in adults. , 1980, Seminars in oncology.

[36]  K. Rothman.  Estimation of confidence limits for the cumulative probability of survival in life table analysis. , 1978, Journal of chronic diseases.