{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:01:21Z","timestamp":1787500881609,"version":"build-2736575974"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"25","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2007,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We analyzed the prevalence, clinical pattern, and prognostic impact of CNS involvement in a large cohort of children and adolescents diagnosed with non-Hodgkin's lymphoma (NHL), with special attention to differences according to NHL subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>From October 1986 to December 2002, 2,381 patients (median age, 9.37 years; range, 0.2 to 23.8 years; female-to-male ratio, 1:2.7) from Germany, Austria, and Switzerland were registered. A total of 2,086 patients were eligible for the consecutive multicenter protocols NHL\u2013Berlin-Frankfurt-M\u00fcnster [BFM] -86, NHL-BFM-90, and NHL-BFM-95, and could be evaluated for outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CNS involvement was diagnosed in 141 (5.9%) of 2,381 patients and was associated with an advanced stage of NHL. The percentage of CNS-positive patients was 8.8% for Burkitt's lymphoma\/Burkitt's leukemia (BL\/B-ALL), 5.4% for precursor B\u2013lymphoblastic lymphoma (pB-LBL), 3.3% for anaplastic large-cell lymphoma, 3.2% for T-cell\u2013LBL, 2.6% for diffuse large B-cell lymphoma, and 0% for primary mediastinal large B-cell NHL (P &lt; .001). Most CNS-positive patients with pB-LBL, T-LBL, or BL\/B-ALL had meningeal disease. The probability of event-free survival (pEFS; \u00b1 SE) at 5 years was 85% \u00b1 1% for the 2,086 protocol patients (median follow-up, 6.5 years; range, 0.3 to 17.7 years). For the 112 CNS-positive patients, pEFS was 64% \u00b1 5%, compared with 86% \u00b1 1% for the 1,927 CNS-negative patients (P &lt; .001). Although CNS disease had no impact on pEFS for advanced-stage T-LBL patients, CNS-positive patients with BL\/B-ALL had a worse average outcome than CNS-negative patients with stage IV BL\/B-ALL (60% \u00b1 5% v 81% \u00b1 3%; P &lt; .001). In multivariate analysis, CNS disease was the strongest predictor for relapse in BL\/B-ALL patients with advanced-stage disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Six percent of childhood\/adolescent NHL patients were CNS positive. However, the prevalence, pattern, and prognostic impact of CNS involvement differed among NHL subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2007.11.0700","type":"journal-article","created":{"date-parts":[[2007,8,30]],"date-time":"2007-08-30T18:23:26Z","timestamp":1188498206000},"page":"3915-3922","source":"Crossref","is-referenced-by-count":95,"title":["Prevalence, Clinical Pattern, and Outcome of CNS Involvement in Childhood and Adolescent Non-Hodgkin's Lymphoma Differ by Non-Hodgkin's Lymphoma Subtype: A Berlin-Frankfurt-M\u00fcnster Group Report"],"prefix":"10.1200","volume":"25","author":[{"given":"Janina","family":"Salzburg","sequence":"first","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Wachowski","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelm","family":"Woessmann","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilske","family":"Oschlies","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"Klapper","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Heinrich","family":"Wacker","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf-Dieter","family":"Ludwig","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Niggli","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Mann","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; 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Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; Department of Pediatric..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schrappe","sequence":"additional","affiliation":[{"name":"From the Department of Pediatric Hematology and Oncology, Justus-Liebig-University, Giessen; Department of Hematopathology and Lymph Node Registry, and Children's University Hospital, University Hospital Schleswig-Holstein, Campus Kiel, Kiel; Department of Hematology, Oncology, and Tumor Immunology, Robert-R\u00f6ssle-Clinic at the HELIOS Klinikum Berlin-Buch, Charit\u00e9 Medical School, Berlin; Department of Pediatric Hematology and Oncology, Medical School Hannover, Hannover, Germany; 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