The Indian Journal of Pediatrics

, Volume 85, Issue 9, pp 782–784 | Cite as

Outcome of Early Stage Pediatric Non-Lymphoblastic Non-Hodgkin Lymphoma

  • Amol Patel
  • Mehar Chand Sharma
  • Sameer BakhshiEmail author
Clinical Brief


There is lack of data on outcome of limited stage pediatric non-Hodgkin lymphoma (NHL) from south Asia. In view of this lacuna, authors evaluated patients of early stage (stage 1 and 2) non-lymphoblastic pediatric NHL patients treated with uniform short course, reduced-intensity protocol from Jan 2003 through Dec 2016. Of the total 280 subjects with pediatric NHL, 50 were of early stage of which 42 received uniform protocol. B-cell subtype was observed in 83% patients. Event-free-survival (EFS) and overall-survival (OS) were 85% and 90% respectively at 5 y (median-not reached). Age > 13 y emerged as the only poor risk factor for EFS (p = 0.05) on univariate analysis and same had a trend toward inferior prognosis in OS (p = 0.09). Vincristine-induced neuropathy occurred in five patients. Febrile neutropenia was observed in 16% subjects with one patient requiring hospitalization. There was no treatment-related death. This largest data of limited stage pediatric non-lymphoblastic NHL from south Asia highlights that good outcomes may be achieved with less intense short course therapy without hospitalization, and that adolescent age is the only poor prognostic factor for outcome.


Non-Hodgkin lymphoma Early stage Outcome 



AP and SB: Manuscript writing, data collection, analysis; MCS: Slides review of all the pathology diagnosis. SB will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest


Supplementary material

12098_2017_2585_MOESM1_ESM.doc (27 kb)
Supplemental Table 1 (DOC 27 kb)
12098_2017_2585_MOESM2_ESM.doc (36 kb)
Supplemental Table 2 (DOC 36 kb)
12098_2017_2585_MOESM3_ESM.doc (44 kb)
Supplemental Table 3 (DOC 44 kb)


  1. 1.
    Link MP, Shuster JJ, Donaldson SS, Berard CW, Murphy SB. Treatment of children and young adults with early-stage non-Hodgkin’s lymphoma. N Engl J Med. 1997;337:1259–66.CrossRefPubMedGoogle Scholar
  2. 2.
    Patte C, Auperin A, Michon J, et al. The Société Française d’Oncologie Pédiatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood. 2001;97:3370–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Cairo MS, Sposto R, Gerrard M, et al. Advanced stage, increased lactate dehydrogenase, and primary site, but not adolescent age (>= 15 years), are associated with an increased risk of treatment failure in children and adolescents with mature B-cell non-hodgkin’s lymphoma: results of the FAB LMB 96 study. J Clin Oncol. 2012;30:387–93.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Murphy SB, Fairclough DL, Hutchison RE, Berard CW. Non-Hodgkin’s lymphomas of childhood: an analysis of the histology, staging, and response to treatment of 338 cases at a single institution. J Clin Oncol. 1989;7:186–93.CrossRefPubMedGoogle Scholar
  5. 5.
    Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H. WHO classification of Tumours of Haematopoietic and lymphoid tissues. Lyon: IARC Press; 2008.Google Scholar
  6. 6.
    Pillon M, Di Tullio MT, Garaventa A, et al. Long-term results of the first Italian Association of Pediatric Hematology and Oncology protocol for the treatment of pediatric B-cell non-Hodgkin lymphoma (AIEOP LNH92). Cancer. 2004;101:385–94.CrossRefPubMedGoogle Scholar
  7. 7.
    Burkhardt B, Zimmermann M, Oschlies I, et al. The impact of age and gender on biology, clinical features and treatment outcome of non-Hodgkin lymphoma in childhood and adolescence. Br J Haematol. 2005;131:39–49.CrossRefPubMedGoogle Scholar
  8. 8.
    Miles RR, Arnold S, Cairo MS. Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia. Br J Haematol. 2012;156:730–43.CrossRefPubMedGoogle Scholar
  9. 9.
    Advani S, Pai S, Adde M, et al. Preliminary report of an intensified, short duration chemotherapy protocol for the treatment of pediatric non-Hodgkin’s lymphoma in India. Ann Oncol. 1997;8:893–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Reiter A, Schrappe M, Tiemann M, et al. Improved treatment results in childhood B-cell neoplasms with tailored intensification of therapy: a report of the Berlin-Frankfurt-Münster group trial NHL-BFM 90. Blood. 1999;94:3294–306.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2018

Authors and Affiliations

  • Amol Patel
    • 1
  • Mehar Chand Sharma
    • 2
  • Sameer Bakhshi
    • 1
    Email author
  1. 1.Department of Medical OncologyDr B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of PathologyAll India Institute of Medical SciencesNew DelhiIndia

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