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Leukemia & Lymphoma

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Childhood Non-Hodgkin Lymphoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Childhood Non-Hodgkin Lymphoma (NHL)



Lymphoma (Hodgkin lymphoma and NHL) is the third most common childhood malignancy, and NHL accounts for approximately 7% of cancers in children younger than 20 years.[3,4] In the United States, about 800 new cases of NHL are diagnosed each year. The incidence is approximately ten cases per million people per year. The incidence of NHL observed in children and adolescents varies depending on age, histology, gender, and race.[3] Although there is no sharp age peak, childhood NHL occurs most commonly in the second decade of life, and occurs infrequently in children younger than 3 years.[3] NHL in infants is very rare (1% in Berlin-Frankfurt-Munster [BFM] trials from 1986 to 2002).[5] The incidence of NHL is increasing overall, which is accounted for because of a slight increase in the incidence for those aged 15 to 19 years; however, the incidence of NHL in children younger than 15 years has remained constant over the past several decades.[3]

Childhood NHL is more common in males than in females, with the exception of primary mediastinal B-cell lymphoma, in which the incidence is almost the same in males and females.[3,6] A review of Surveillance, Epidemiology, and End Results (SEER) data on Burkitt lymphoma diagnosed in the United States between 1992 and 2008 revealed 2.5 cases/million person-years with more cases in males than in females (3.9:1.1). The incidence of diffuse large B-cell lymphoma increases with age in both males and females. The incidence of lymphoblastic lymphoma remains relatively constant across ages for both males and females.

The incidence and age distribution of specific types of NHL according to gender is described in Table 1.

Table 1. Incidence and Age Distribution of Specific Types of NHLa

Incidence of NHL per million person-years
ALCL = anaplastic large cell lymphoma; DLBCL = diffuse large B-cell lymphoma; NHL = non-Hodgkin lymphoma.
a Adapted from Percy et al.[3]
b In older adolescents, indolent and aggressive histologies (more commonly seen in adult patients) are beginning to be found.
Males Females
Age (y) <5 5-9 10-14 15-19 <5 5-9 10-14 15-19
Burkitt 3.2 6 6.1 2.8 0.8 1.1 0.8 1.2
Lymphoblastic 1.6 2.2 2.8 2.2 0.9 1.0 0.7 0.9
DLBCL 0.5 1.2 2.5 6.1 0.6 0.7 1.4 4.9
Other (mostly ALCL) 2.3 3.3 4.3 7.8b 1.5 1.6 2.8 3.4b
1 | 2 | 3
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