B-CELL LINEAGE CONFERS A FAVORABLE OUTCOME AMONG CHILDREN AND ADOLESCENTS WITH LARGE-CELL LYMPHOMA - A PEDIATRIC-ONCOLOGY-GROUP STUDY

Purpose: The goal of this study was to assess the immunophenotype of u niformly treated cases of pediatric large-cell non-Hodgkin's lymphoma (NHL) to determine the prognostic importance of B-cell and T-cell line ages and of CD30 positivity. Patients and Methods: Sixty-nine patients were analyzed by immunochemistry. All patients were classified histol ogically, staged in a uniform manner, and treated according to one of two protocols for localized (stage I and II) NHL or advanced (stage II I and IV) large-cell NHL. Antibodies included anti-CD45, CD20, CD45Ra, MB-2 (not clustered), CD3, CD45Ro, CD43, CD15, CD30, and CD68. Statis tical analysis used the exact conditional chi(2) and Kruskall-Wallace tests for clinical features and the log-rank test to evaluate event-fr ee survival (EFS). Results: Immunophenotypic results demonstrated 25 B -cell, 23 T-cell, and 21 indeterminate lineage. Twenty-seven patients expressed CD30 (17 T-cell and 10 indeterminate lineage), and of these, 22 showed histology of anaplastic large-cell lymphoma (ALCL). B-cell patients were older (P = .018) and showed more favorable survival than patients with T-cell or indeterminate lineage (96% EFS at 3 years, 96 % v 67% and 74%, B v T and indeterminate lineage [P = .027]). B-cell l ineage was seen more frequently in limited-stage patients, but was als o associated with favorable survival when stratified for stage (P = .0 36). CD30 expression (P = .96) and ALCL histology (P = .90) did not sh ow significant associations with survival. Conclusion: We conclude tha t among pediatric large-cell lymphomas, B-cell lineage is proportionat ely less frequent than in adults and CD30 antigen-expressing lymphomas are frequent among patients with T-cell and indeterminate lineage. B- cell phenotype tends to occur in older children and is associated with superior survival. (C) 1995 by American Society of Clinical Oncology.