OUTCOME AND TOXICITY PATTERNS IN CHILDREN AND ADOLESCENTS WITH NON-HODGKIN LYMPHOMA: A SINGLE INSTITUTION EXPERIENCE

Background : The incidence and biology of non-Hodgkin lymphoma (NHL) vary according to age. Some data suggest that the impact of age in pediatric and adolescent NHL patients depends on the histological subtype. Objectives : We aimed to analyze the impact of age at diagnosis on clinical characteristics and treatment-related toxicity in children and adolescents with NHL. Methods : Retrospective review of medical records of children and adolescents diagnosed with NHL at the Hospital for Sick children, Toronto, between January 1995 and December 2008. Results: 164 children were diagnosed with NHL during the study period, with a median age at diagnosis of 10 years. With a median follow-up of 6.2 years, 5-year OS in patients aged <15 and 15-18 years was 89± 2% vs 82% ± 6%, respectively ( P = 0.30), and 5-year EFS was 84% ± 3% vs. 77% ± 7%  ( P = 0.37). In Burkitts lymphoma (BL) and lymphoblastic lymphoma (LL) there was a trend towards better outcomes in children compared to adolescents, with EFS of  91% ± 4% vs. 75% ± 15%, respectively in BL ( P = 0.17),  and 82% ± 7% vs. 51.4% ± 2% respectively in LL ( P = 0.16). Late effects occurred in 21 patients (12.8%). Conclusions: Children with NHL aged < 15 years tend to have better survival rates and less long-term toxicity than adolescents aged 15-18 years.