Testicular disease in childhood B-cell non-Hodgkin's lymphoma: The French Society of Pediatric Oncology experience

Purpose: To investigate whether testicular disease in childhood B-cell lymp homa should continue to be considered a sanctuary site, as it is with of he r lymphoid malignancies such as acute lymphoblastic leukemia. Patients and Methods: Seven hundred forty-two children with B cell non-Hodg kin's lymphoma were included in the LMB protocols of the French Society of Pediatric Oncology from February 1981 to May 1994. Thirty patients (5.3%) h erd testicular involvement at diagnosis. We describe the clinical presentat ion and outcome of these 30 patients, who were treated without total radiat ion therapy. Results: Five patients underwent diagnostic orchidectomy. The median patien t age was 8.5 years (range, 2 to 14 years), and their cancers were stage II I (18 patients), stage IV (five patients), and B-cell acute lymphoblastic l eukemia (seven patients). Five patients had central nervous system involvem ent. Twenty-eight patients (95%) achieved complete remission. Twenty-six pa tients are alive without progressive disease (median follow-up, 6.5 years). Conclusion: Testicular disease does not seem to confer a poor prognosis, an d it is curable with intensive combination chemotherapy alone. Local treatm ent (surgery or radiation) is avoidable; therefore, gonadal function can be preserved. J Clin Oncol 19:2397-2403. (C) 2001 by American Society of Clin ical Oncology.