What is the prognosis of pediatric non-Hodgkin lymphoma (NHL)?

Updated: Jun 14, 2018
  • Author: J Martin Johnston, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

The overall prognosis for children with non-Hodgkin lymphoma has steadily improved. Period analysis of SEER data for children under 15 years showed that 5- and 10-year survival increased, respectively, from 76.6% and 73.0% in 1990-1994 to 87.7% and 86.9% in 2000-2004. The projected 10-year survival rate for children diagnosed in 2005-2009 was 90.6%. [28]

Among patients with non-Hodgkin lymphoma, the major determinants of prognosis are histology and disease stage. The presence or absence of particular molecular markers (eg, anaplastic lymphoma kinase (ALK) and/or CD56 in anaplastic large cell lymphoma [LCL]) has additional prognostic significance. [29]

Age at diagnosis is a significant prognostic factor when one considers the older pediatric patient (adolescent or young adult) with non-Hodgkin lymphoma. Broadly speaking, older patients have poorer outcomes, [30] and there is increasing recognition that these patients need to be viewed as a unique population in terms of disease biology and treatment tolerance. [31]

Studies have also defined host (ie, nontumoral) prognostic factors for patients with non-Hodgkin lymphoma. For example, polymorphisms of immune-related genes, such as those for interleukin (IL)–10 and tumor necrosis factor, show significant associations with treatment outcomes in adults with non-Hodgkin lymphoma. [32, 33] Similar pediatric data are not yet available.


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