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Response Assessment in Pediatric Non-Hodgkin Lymphoma

  • Tony H. TruongEmail author
  • Veronique Minard-Colin
Chapter

Abstract

Response assessment is the clinical, biopathological, and radiological evaluation of disease at an interim time point during treatment or at the end of the therapy to determine and evaluate the success of therapy. Response determination during therapy for non-Hodgkin lymphoma is important because intensification of therapy for those with residual disease has been proven to be beneficial in some tumor types. Histological confirmation remains the gold standard to differentiate active residual disease from tumor necrosis or inflammatory scar tissue and allows for the application of highly sensitive techniques such as immunophenotyping by flow cytometry, cytogenetics and FISH analysis, and molecular PCR methods. Conventional cross-sectional imaging modalities such as CT are appealing for its ability to assess the entire tumor, is widely available and minimally invasive. Functional imaging with FDG-PET, though not available at all centers, has become an invaluable tool in staging and response assessment, but its role remains unclear and needs to be further evaluated in pediatric NHL. As pediatric NHL is well recognized to be a different spectrum of disease than adult NHL, the need for separate pediatric criteria led to a multidisciplinary collaboration resulting in the development of the International Pediatric NHL Response Criteria. Future use and adoption of these standardized criteria will allow for comparison of treatment efficacy across multiple regimens and improve clinical decision-making.

Keywords

Response Staging Residual disease Imaging FDG-PET Criteria SPPD Histology Necrosis Evaluation 

References

  1. 1.
    Agsalda M, Kusao I, Troelstrup D, Shiramizu B. Screening for residual disease in pediatric burkitt lymphoma using consensus primer pools. Adv Hematol. 2009;2009:412163.CrossRefGoogle Scholar
  2. 2.
    Bhojwani D, McCarville MB, Choi JK, Sawyer J, Metzger ML, Inaba H, Davidoff AM, Gold R, Shulkin BL, Sandlund JT. The role of FDG-PET/CT in the evaluation of residual disease in paediatric non-Hodgkin lymphoma. Br J Haematol. 2015;168(6):845–53.CrossRefGoogle Scholar
  3. 3.
    Borowitz MJ, Devidas M, Hunger SP, Bowman WP, Carroll AJ, Carroll WL, Linda S, Martin PL, Pullen DJ, Viswanatha D, Willman CL, Winick N, Camitta BM, Children’s Oncology Group. Clinical significance of minimal residual disease in childhood acute lymphoblastic leukemia and its relationship to other prognostic factors: a Children’s Oncology Group study. Blood. 2008;111(12):5477–85.CrossRefGoogle Scholar
  4. 4.
    Cairo M, Gerrard M, Sposto R, et al. Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents. Blood. 2007;109(7):2736–43.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, Lister TA, Alliance, Australasian Leukaemia and Lymphoma Group, Eastern Cooperative Oncology Group, European Mantle Cell Lymphoma Consortium, Italian Lymphoma Foundation, European Organisation for Research, Treatment of Cancer/Dutch Hemato-Oncology Group, Grupo Espanol de Medula Osea, German High-Grade Lymphoma Study Group, German Hodgkin’s Study Group, Japanese Lymphorra Study Group, Lymphoma Study Association, NCIC Clinical Trials Group, Nordic Lymphoma Study Group, Southwest Oncology Group, United Kingdom National Cancer Research Institute. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059–68.CrossRefGoogle Scholar
  6. 6.
    Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol. 1999;17(4):1244–53.CrossRefGoogle Scholar
  7. 7.
    Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, Coiffier B, Fisher RI, Hagenbeek A, Zucca E, Rosen ST, Stroobants S, Lister TA, Hoppe RT, Dreyling M, Tobinai K, Vose JM, Connors JM, Federico M, Diehl V, International Harmonization Project on Lymphoma. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579–86.CrossRefGoogle Scholar
  8. 8.
    Coustan-Smith E, Sandlund JT, Perkins SL, Chen H, Chang M, Abromowitch M, Campana D. Minimal disseminated disease in childhood T-cell lymphoblastic lymphoma: a report from the children’s oncology group. J Clin Oncol. 2009;27(21):3533–9.CrossRefGoogle Scholar
  9. 9.
    Damm-Welk C, Klapper W, Oschlies I, Gesk S, Rottgers S, Bradtke J, Siebert R, Reiter A, Woessmann W. Distribution of NPM1-ALK and X-ALK fusion transcripts in paediatric anaplastic large cell lymphoma: a molecular-histological correlation. Br J Haematol. 2009;146(3):306–9.CrossRefGoogle Scholar
  10. 10.
    Damm-Welk C, Mussolin L, Zimmermann M, Pillon M, Klapper W, Oschlies I, d’Amore ES, Reiter A, Woessmann W, Rosolen A. Early assessment of minimal residual disease identifies patients at very high relapse risk in NPM-ALK-positive anaplastic large-cell lymphoma. Blood. 2014;123(3):334–7.CrossRefGoogle Scholar
  11. 11.
    Eissa HM, Allen CE, Kamdar K, Simko S, Goradia P, Dreyer Z, Steuber P, McClain KL, Guillerman RP, Bollard CM. Pediatric Burkitt’s lymphoma and diffuse B-cell lymphoma: are surveillance scans required? Pediatr Hematol Oncol. 2014;31(3):253–7.CrossRefGoogle Scholar
  12. 12.
    Meignan M, Gallamini A, Meignan M, Gallamini A, Haioun C. Report on the First International Workshop on Interim-PET-Scan in Lymphoma. Leuk Lymphoma. 2009;50(8):1257–60.CrossRefGoogle Scholar
  13. 13.
    Minard-Colin V, Brugieres L, Reiter A, Cairo MS, Gross TG, Woessmann W, Burkhardt B, Sandlund JT, Williams D, Pillon M, Horibe K, Auperin A, Le Deley MC, Zimmerman M, Perkins SL, Raphael M, Lamant L, Klapper W, Mussolin L, Poirel HA, Macintyre E, Damm-Welk C, Rosolen A, Patte C. Non-Hodgkin lymphoma in children and adolescents: progress through effective collaboration, current knowledge, and challenges ahead. J Clin Oncol. 2015;33(27):2963–74.CrossRefGoogle Scholar
  14. 14.
    Mussolin L, Damm-Welk C, Pillon M, Zimmermann M, Franceschetto G, Pulford K, Reiter A, Rosolen A, Woessmann W. Use of minimal disseminated disease and immunity to NPM-ALK antigen to stratify ALK-positive ALCL patients with different prognosis. Leukemia. 2013;27(2):416–22.CrossRefGoogle Scholar
  15. 15.
    Paganin M, Fabbri G, Conter V, Barisone E, Polato K, Cazzaniga G, Giraldi E, Fagioli F, Arico M, Valsecchi MG, Basso G. Postinduction minimal residual disease monitoring by polymerase chain reaction in children with acute lymphoblastic leukemia. J Clin Oncol. 2014;32(31):3553–8.CrossRefGoogle Scholar
  16. 16.
    Patte C, Auperin A, Gerrard M, Michon J, Pinkerton R, Sposto R, Weston C, Raphael M, Perkins SL, McCarthy K, Cairo MS, FAB/LMB96 International Study Committee. Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood. 2007;109(7):2773–80.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Patte C, Auperin A, Michon J, Behrendt H, Leverger G, Frappaz D, Lutz P, Coze C, Perel Y, Raphael M, Terrier-Lacombe MJ. The Societe Francaise d’Oncologie Pediatrique 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(11):3370–9.CrossRefGoogle Scholar
  18. 18.
    Pillon M, Mussolin L, Carraro E, Conter V, Arico M, Vinti L, Garaventa A, Piglione M, Buffardi S, Sala A, Santoro N, Lo Nigro L, Mura R, Tondo A, Casale F, Farruggia P, Pierani P, Cesaro S, d’Amore ES, Basso G. Detection of prognostic factors in children and adolescents with Burkitt and Diffuse Large B-Cell Lymphoma treated with the AIEOP LNH-97 protocol. Br J Haematol. 2016;175(3):467–75.CrossRefGoogle Scholar
  19. 19.
    Reiter A, Schrappe M, Parwaresch R, Henze G, Muller-Weihrich S, Sauter S, Sykora KW, Ludwig WD, Gadner H, Riehm H. Non-Hodgkin’s lymphomas of childhood and adolescence: results of a treatment stratified for biologic subtypes and stage – a report of the Berlin-Frankfurt-Munster Group. J Clin Oncol. 1995;13(2):359–72.CrossRefGoogle Scholar
  20. 20.
    Reiter A, Schrappe M, Tiemann M, Ludwig WD, Yakisan E, Zimmermann M, Mann G, Chott A, Ebell W, Klingebiel T, Graf N, Kremens B, Muller-Weihrich S, Pluss HJ, Zintl F, Henze G, Riehm H. Improved treatment results in childhood B-cell neoplasms with tailored intensification of therapy: a report of the Berlin-Frankfurt-Munster Group Trial NHL-BFM 90. Blood. 1999;94(10):3294–306.PubMedGoogle Scholar
  21. 21.
    Riad R, Omar W, Sidhom I, Zamzam M, Zaky I, Hafez M, Abdel-Dayem HM. False-positive F-18 FDG uptake in PET/CT studies in pediatric patients with abdominal Burkitt’s lymphoma. Nucl Med Commun. 2010;31(3):232–8.CrossRefGoogle Scholar
  22. 22.
    Roschewski M, Dunleavy K, Pittaluga S, Moorhead M, Pepin F, Kong K, Shovlin M, Jaffe ES, Staudt LM, Lai C, Steinberg SM, Chen CC, Zheng J, Willis TD, Faham M, Wilson WH. Circulating tumour DNA and CT monitoring in patients with untreated diffuse large B-cell lymphoma: a correlative biomarker study. Lancet Oncol. 2015;16(5):541–9.CrossRefGoogle Scholar
  23. 23.
    Sandlund JT, Guillerman RP, Perkins SL, Pinkerton CR, Rosolen A, Patte C, Reiter A, Cairo MS. International Pediatric non-Hodgkin lymphoma response criteria. J Clin Oncol. 2015;33(18):2106–11.CrossRefGoogle Scholar
  24. 24.
    Shammas A, Lim R, Charron M. Pediatric FDG PET/CT: physiologic uptake, normal variants, and benign conditions. Radiographics. 2009;29(5):1467–86.CrossRefGoogle Scholar
  25. 25.
    Termuhlen AM, Smith LM, Perkins SL, Lones M, Finlay JL, Weinstein H, Gross TG, Abromowitch M. Disseminated lymphoblastic lymphoma in children and adolescents: results of the COG A5971 trial: a report from the Children’s Oncology Group. Br J Haematol. 2013;162(6):792–801.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Oncology and PediatricsAlberta Children’s Hospital, University of CalgaryCalgaryCanada
  2. 2.Department of Pediatric and Adolescent OncologyGustave RoussyVillejuifFrance

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