Childhood non-Hodgkin's lymphomas: clinical and therapeutic aspects

Childhood non-Hodgkin's lymphomas (NHL) are a heterogeneous group. Biological studies have shown that most mediastinal NHL are lymphoblastic lymphomas which are T-cell tumors. In contrast, most NHL occurring in the gastrointestinal tract, abdominal cavity and Waldeyer's ring are diffuse undifferentiated small non-cleaved lymphomas, mainly Burkitt's or Burkitt-like lymphomas. Different multi-drug combinations have been proposed over the last 20 years. The LSA2-L2 regimen or other protocols, based on acute lymphoblastic leukemia results, have improved the prognosis in T-cell NHL. In extended B-cell NHL, aggressive short term multi-drug chemotherapy given in pulses gives a cure rate above 60%. The use of surgery and radiotherapy in the treatment of childhood NHL has decreased with the realisation that most children can be cured by chemotherapy alone.