Germinal-center type B-cell classification and clinical characteristics of Chinese pediatric diffuse large B-cell lymphoma： a report of 76 cases

Pediatric diffuse large B-cell lymphoma （DLBCL） is a highly aggressive disease with unique clinical characteristics. This study analyzed the germinal-center type B-cell （GCB） classification and clinical characteristics of Chinese pediatric DLBCL. A total of 76 patients with DLBCL newly diagnosed in Sun Yat- sen University Cancer Center between February 2000 and May 2011, with an age younger than 18 years, were included in the analysis. The male/female ratio was 3.47：1. The median age was 12 years （range, 2 to 18 years）, and 47 （61.8%） patients were at least 10 years old. Of the 76 patients, 48 （63.2%） had stage Ill/IV disease, 9 （11.8%） had bone marrow involvement, 1 （1.3%） had central nervous system （CNS） involvement, and 5 （6.6%） had bone involvement. The GCB classification was assessed in 45 patients： 26 （57.8%） were classified as GCB subtype, and 19 （42.2%） were classified as non-GCB subtype. The modified B-NHL-BFM-90/95 regimen was administered to 50 patients, and the 4-year event-free survival （EFS） rate was 85.8%. Among these 50 patients, 31 were assessed for the GCB classification： 17 （54.8%） were classified as GCB subtype, with a 4-year EFS rate of 88.2%; 14 （45.2%） were classified as non-GCB subtype, with a 4-year EFS rate of 92.9%. Our data indicate that bone marrow involvement and stage III/ IV disease are common in Chinese pediatric DLBCL patients, whereas the percentage of patients with the GCB subtype is similar to that of patients with the non-GCB subtype. The modified B-NHL-BFM-90/95 protocol is an active and effective treatment protocol for Chinese pediatric patients with DLBCL.