{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T16:13:05Z","timestamp":1785600785709,"version":"3.56.0"},"reference-count":20,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006244","name":"Kinderen Kankervrij","doi-asserted-by":"publisher","award":["393"],"award-info":[{"award-number":["393"]}],"id":[{"id":"10.13039\/501100006244","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006244","name":"Kinderen Kankervrij","doi-asserted-by":"publisher","award":["DKS 2014.11"],"award-info":[{"award-number":["DKS 2014.11"]}],"id":[{"id":"10.13039\/501100006244","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006244","name":"Kinderen Kankervrij","doi-asserted-by":"publisher","award":["DKS 2016.24"],"award-info":[{"award-number":["DKS 2016.24"]}],"id":[{"id":"10.13039\/501100006244","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Deutsche Kinderkrebsstiftung","award":["393"],"award-info":[{"award-number":["393"]}]},{"name":"Deutsche Kinderkrebsstiftung","award":["DKS 2014.11"],"award-info":[{"award-number":["DKS 2014.11"]}]},{"name":"Deutsche Kinderkrebsstiftung","award":["DKS 2016.24"],"award-info":[{"award-number":["DKS 2016.24"]}]},{"name":"Deutsche Kinderkrebsstiftung","award":["393"],"award-info":[{"award-number":["393"]}]},{"name":"Deutsche Kinderkrebsstiftung","award":["DKS 2014.11"],"award-info":[{"award-number":["DKS 2014.11"]}]},{"name":"Deutsche Kinderkrebsstiftung","award":["DKS 2016.24"],"award-info":[{"award-number":["DKS 2016.24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>B-cell lymphoblastic lymphoma (BCP-LBL) and B-cell acute lymphoblastic leukemia (BCP-ALL) are the malignant counterparts of immature B-cells. BCP-ALL is the most common hematological malignancy in childhood, while BCP-LBL accounts for only 1% of all hematological malignancies in children. Therefore, BCP-ALL has been well studied and treatment protocols have changed over the last decades, whereas treatment for BCP-LBL has stayed roughly the same. Clinical characteristics of 364 pediatric patients with precursor B-cell malignancies were studied, consisting of BCP-LBL (n = 210) and BCP-ALL (n = 154) patients. Our results indicate that based on the clinical presentation of disease, B-cell malignancies probably represent a spectrum ranging from complete isolated medullary disease to apparent complete extramedullary disease. Hepatosplenomegaly and peripheral blood involvement are the most important discriminators, as both seen in 80% and 95% of the BCP-ALL patients and in 2% of the BCP-LBL patients, respectively. In addition, we show that the overall survival rates in this cohort differ significantly between BCP-LBL and BCP-ALL patients aged 1\u201318 years (p = 0.0080), and that the outcome for infants (0\u20131 years) with BCP-LBL is significantly decreased compared to BCP-LBL patients of all other pediatric ages (p &lt; 0.0001).<\/jats:p>","DOI":"10.3390\/cancers14163895","type":"journal-article","created":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T21:09:06Z","timestamp":1660511346000},"page":"3895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pediatric Precursor B-Cell Lymphoblastic Malignancies: From Extramedullary to Medullary Involvement"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4258-1291","authenticated-orcid":false,"given":"Emma","family":"Kroeze","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Arias Padilla","sequence":"additional","affiliation":[{"name":"NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Bakker","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4848-7789","authenticated-orcid":false,"given":"Judith M.","family":"Boer","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie M.","family":"Hagleitner","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-829X","authenticated-orcid":false,"given":"Birgit","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0029-7265","authenticated-orcid":false,"given":"Takeshi","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Hyogo Prefectural Kobe Children\u2019s Hospital, Kobe 650-0047, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9285-6898","authenticated-orcid":false,"given":"Andishe","family":"Attarbaschi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, St. Anna Children\u2019s Hospital, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Verd\u00fa-Amor\u00f3s","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, Hospital Cl\u00ednico Universitario de Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-3198","authenticated-orcid":false,"given":"Marta","family":"Pillon","sequence":"additional","affiliation":[{"name":"Clinic of Pediatric Hemato-Oncology, Department of Women\u2019s and Children\u2019s Health, University of Padova, 46010 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliya","family":"Anderzhanova","sequence":"additional","affiliation":[{"name":"Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 117198 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edita","family":"Kab\u00ed\u010dkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Charles University, 2nd Medical School and University Hospital Motol, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-5325","authenticated-orcid":false,"given":"Alan K. S.","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4344-8174","authenticated-orcid":false,"given":"Rejin","family":"Kebudi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology-Oncology, Istanbul University, Oncology Institute, 34452 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Mellgren","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-2069","authenticated-orcid":false,"given":"Jelena","family":"Lazic","sequence":"additional","affiliation":[{"name":"Department for Hematology and Oncology, University Children\u2019s Hospital, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7426-1591","authenticated-orcid":false,"given":"Janez","family":"Jazbec","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, Hematology and Oncology, University Medical Center Ljubljana, SI-1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6860-798X","authenticated-orcid":false,"given":"Jules P. P.","family":"Meijerink","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Auke","family":"Beishuizen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"},{"name":"Erasmus Medical Center, Sophia Children\u2019s Hospital, 3015 CN Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan L. C.","family":"Loeffen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1038\/s41375-020-01024-0","article-title":"Progress against childhood and adolescent acute lymphoblastic leukaemia in the Netherlands, 1990\u20132015","volume":"35","author":"Reedijk","year":"2021","journal-title":"Leukemia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/s12185-013-1364-2","article-title":"Incidence and survival rates of hematological malignancies in Japanese children and adolescents (2006\u20132010): Based on registry data from the Japanese Society of Pediatric Hematology","volume":"98","author":"Horibe","year":"2013","journal-title":"Int. J. 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