Pediatric B-cell Non-Hodgkin Lymphoma: 21-year Experience with FAB-LMB Protocols in a Single Institute in Greece

Aims and background: Our objective was to analyze the clinical and demographic characteristics of children with B-cell lymphoma treated in a single center over the last two decades. Methods: Data was collected by a retrospective review of the charts of all 76 patients treated to our unit, from 1990 to 2010, with FAB LMB 89, 96 protocols and 2003 modifications. Results: The median age was 8.03 years, with a male predominance 3.7:1. According to LMB staging criteria, 7 patients (9.2%) were classified as Group A, 53 (69.7%) as B and 16 (21.1%) as C all but 1 with bone marrow involvement and in 8 combined with CNS involvement. Most of our patients (46/76 - 60.5%) had abdominal tumours. Eight children of A and B Group (8/60, 13.3%) were upgraded to Group C due to poor treatment response. Regarding outcome, 11 patients died, 8 due to disease, 3 due to toxicity, 2 in induction and 1 post autograft. Relapse occurred in 10 children (13.2%), all with abdominal disease, one of them with concurrent mediastinal involvement. Most relapsed patients (7/10) were initially treated as Group B (7/53, 13.2%), 2 as C and 1 as Group A. The outcome of relapsed children was dismal, as 6/10 (60%) died. Conclusions: In our results, the survival rate is generally excellent (65/76, 85.53 %) more than one year off treatment, which generally means cure in B-cell lymphomas. Children with unsatisfactory response to treatment and recurrent disease have a dismal prognosis.