Natural killer cell lymphoma

Report of two pediatric cases, therapeutic options, and review of the literature

Peter Shaw, Susan L. Cohn, Elaine R. Morgan, Paula Kovarik, Paul R. Haut, Morris Kletzel, Sharon B. Murphy

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Natural killer (NK) cell lymphomas are rapidly fatal malignancies that to the authors' knowledge are rare in children. In the current study, the authors report the cases of two boys with NK cell lymphomas with refractory disease who both were salvaged with high dose chemotherapy and stem cell transplantation and compare these patients with those in the published experience. METHODS. A comprehensive literature review was performed to identify other cases of pediatric patients with NK cell lymphomas, their treatment, and outcome. RESULTS. One of the patients in the current study developed two recurrences and the other patient experienced early disease progression during front-line treatment. Both then were treated with high dose chemotherapy followed by stem cell rescue. At last follow-up, the patients remained free of disease at 15 months and 16 months, respectively, after transplantation (48 months and 22 months, respectively, from the time of diagnosis). In addition to the 2 patients in the current study, the authors found 13 pediatric patients reported in the literature to date. Of the 7 patients with localized (Stage I-II) disease, 5 patients (71%) were reported to be alive 1-107 months after diagnosis. Of the 6 patients with Stage IV disease, only the 2 patients who received high dose chemotherapy and stem cell rescue (33%) were alive at the time of last follow-up (at 30 months and 12 months, respectively). Including the patients reported in the current study, 9 of 15 children with NK cell lymphoma (all stages) (60%) were reported to be alive at the time of last follow-up. CONCLUSIONS. Although pediatric NK cell lymphomas rapidly can become fatal, it appears that high dose chemotherapy followed by stem cell transplantation is effective therapy, especially in patients with advanced or resistant disease. Further follow-up is needed to determine whether this treatment approach will be curative.

Original languageEnglish (US)
Pages (from-to)642-646
Number of pages5
JournalCancer
Volume91
Issue number4
DOIs
StatePublished - Feb 15 2001
Externally publishedYes

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Natural Killer Cells
Lymphoma
Pediatrics
Therapeutics
Drug Therapy
Stem Cell Transplantation
Stem Cells
Disease Progression
Transplantation
Recurrence

Keywords

  • Lymphoma
  • Natural killer cell
  • Pediatric
  • Stem cell transplantation
  • Therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Natural killer cell lymphoma : Report of two pediatric cases, therapeutic options, and review of the literature. / Shaw, Peter; Cohn, Susan L.; Morgan, Elaine R.; Kovarik, Paula; Haut, Paul R.; Kletzel, Morris; Murphy, Sharon B.

In: Cancer, Vol. 91, No. 4, 15.02.2001, p. 642-646.

Research output: Contribution to journalArticle

Shaw, Peter ; Cohn, Susan L. ; Morgan, Elaine R. ; Kovarik, Paula ; Haut, Paul R. ; Kletzel, Morris ; Murphy, Sharon B. / Natural killer cell lymphoma : Report of two pediatric cases, therapeutic options, and review of the literature. In: Cancer. 2001 ; Vol. 91, No. 4. pp. 642-646.
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abstract = "BACKGROUND. Natural killer (NK) cell lymphomas are rapidly fatal malignancies that to the authors' knowledge are rare in children. In the current study, the authors report the cases of two boys with NK cell lymphomas with refractory disease who both were salvaged with high dose chemotherapy and stem cell transplantation and compare these patients with those in the published experience. METHODS. A comprehensive literature review was performed to identify other cases of pediatric patients with NK cell lymphomas, their treatment, and outcome. RESULTS. One of the patients in the current study developed two recurrences and the other patient experienced early disease progression during front-line treatment. Both then were treated with high dose chemotherapy followed by stem cell rescue. At last follow-up, the patients remained free of disease at 15 months and 16 months, respectively, after transplantation (48 months and 22 months, respectively, from the time of diagnosis). In addition to the 2 patients in the current study, the authors found 13 pediatric patients reported in the literature to date. Of the 7 patients with localized (Stage I-II) disease, 5 patients (71{\%}) were reported to be alive 1-107 months after diagnosis. Of the 6 patients with Stage IV disease, only the 2 patients who received high dose chemotherapy and stem cell rescue (33{\%}) were alive at the time of last follow-up (at 30 months and 12 months, respectively). Including the patients reported in the current study, 9 of 15 children with NK cell lymphoma (all stages) (60{\%}) were reported to be alive at the time of last follow-up. CONCLUSIONS. Although pediatric NK cell lymphomas rapidly can become fatal, it appears that high dose chemotherapy followed by stem cell transplantation is effective therapy, especially in patients with advanced or resistant disease. Further follow-up is needed to determine whether this treatment approach will be curative.",
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