{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:47:44Z","timestamp":1793396864725,"version":"4.5.0"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T00:00:00Z","timestamp":1619308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2014.11A\/B, DKS 2016.24A\/B"],"award-info":[{"award-number":["DKS 2014.11A\/B, DKS 2016.24A\/B"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r\/r NHL). The current project aimed to collect international experience on the re-induction treatment of r\/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recommendations. Inclusion criteria were (i) refractory disease, disease progression or relapse of any NHL subtype except anaplastic large cell lymphoma, (ii) age &lt; 18 years at initial diagnosis, (iii) diagnosis in\/after January 2000. Data from 639 eligible patients were evaluable. The eight-year probability of overall survival was 34 \u00b1 2% with highly significant differences according to NHL subtypes: 28 \u00b1 3% for 254 Burkitt lymphoma\/leukemia, 50 \u00b1 6% for 98 diffuse large B-cell lymphomas, 57 \u00b1 8% for 41 primary mediastinal large B-cell lymphomas, 27 \u00b1 3% for 177 T-lymphoblastic lymphomas, 52 \u00b1 10% for 34 precursor-B-cell lymphoblastic lymphomas and 30 \u00b1 9% for 35 patients with rare NHL subtypes. Subtype-specific factors associated with survival and treatment recommendations are suggested. There were no survivors without HSCT, except in few very small subgroups. Conclusions: There is an urgent need to further improve survival in r\/r NHL. The current study provides the largest real-world series, which underlines the role of HSCT and suggests treatment recommendations.<\/jats:p>","DOI":"10.3390\/cancers13092075","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T22:31:39Z","timestamp":1619389899000},"page":"2075","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Treatment and Outcome Analysis of 639 Relapsed Non-Hodgkin Lymphomas in Children and Adolescents and Resulting Treatment Recommendations"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-829X","authenticated-orcid":false,"given":"Birgit","family":"Burkhardt","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and BMT, University Hospital Muenster, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7107-618X","authenticated-orcid":false,"given":"Mary","family":"Taj","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Royal Marsden Hospital, Surrey SM2 5PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Garnier","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Institute of Pediatric Hematology and Oncology, 69002 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Minard-Colin","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Oncology, Gustave Roussy, Universit\u00e9 Paris-Saclay, 94805 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkan","family":"Hazar","sequence":"additional","affiliation":[{"name":"Memorial Healthcare Group Private Antalya Yildiz Hospital, Pediatric Oncology Unit, Antalya 07070, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Mellgren","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Sahlgrenska University Hospital, The Queen Silvia Children\u2019s Hospital, 41685 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5536-6788","authenticated-orcid":false,"given":"Tomoo","family":"Osumi","sequence":"additional","affiliation":[{"name":"Children\u2019s Cancer Centre, National Centre for Child Health and Development, Tokyo 104-0045, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1559-8223","authenticated-orcid":false,"given":"Alina","family":"Fedorova","sequence":"additional","affiliation":[{"name":"Belarusian Research Centre for Pediatric Oncology, Hematology and Immunology, Research Department, 223053 Minsk, Belarus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Myakova","sequence":"additional","affiliation":[{"name":"National Research Centre for Pediatric Hematology, Oncology and Immunology, 129090 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Verdu-Amoros","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, University Hospital Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Andres","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, University Hospital Le Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edita","family":"Kabickova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Charles University &amp; University Hospital Motol, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-6898","authenticated-orcid":false,"given":"Andishe","family":"Attarbaschi","sequence":"additional","affiliation":[{"name":"St. Anna Children\u2019s Hospital, Department of Paediatric Haematology and Oncology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-5325","authenticated-orcid":false,"given":"Alan Kwok Shing","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics &amp; Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Bubanska","sequence":"additional","affiliation":[{"name":"Clinic of Pediatric Oncology and Hematology, Slovak Health University and Children\u2019s Faculty Hospital, 97409 Bansk\u00e1 Bystrica, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Donska","sequence":"additional","affiliation":[{"name":"Centre of Pediatric OncoHematology and BMT, National Ukrainian Children\u2019s Hospital Ochmatdyt, 04070 Kiev, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Lyngsie","family":"Hjalgrim","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4680-603X","authenticated-orcid":false,"given":"Jacek","family":"Wachowiak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60572 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Pieczonka","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, 60572 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5644-424X","authenticated-orcid":false,"given":"Anne","family":"Uyttebroeck","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, University Hospital Leuven, KU Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Lazic","sequence":"additional","affiliation":[{"name":"Department for Hematology and Oncology, University Children\u2019s Hospital, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Loeffen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Centre for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5848-4501","authenticated-orcid":false,"given":"Jochen","family":"Buechner","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Oslo University Hospital, 0424 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Niggli","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, University Children\u2019s Hospital Zurich, 8032 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Csoka","sequence":"additional","affiliation":[{"name":"2nd Department of Pediatrics, Semmelweis University, 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4853-4354","authenticated-orcid":false,"given":"Gergely","family":"Krivan","sequence":"additional","affiliation":[{"name":"Central Hospital of Southern Pest\u2014National Institute of Hematology and Infectious Diseases, Department for Pediatric Hematology and Hemopoietic Stem Cell Transplantation, 1097 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Palma","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hospital Luis Calvo Mackenna, Department of Pediatrics\u2014Bone Marrow Transplantation Unit, University of Chile, Santiago 8820808, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2671-9972","authenticated-orcid":false,"given":"G. 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