Non-Hodgkin's lymphoma: current management

Around 100 new cases of non-Hodgkin's lymphoma are diagnosed each year in the UK, accounting for 7% of childhood cancer. Immunophenotype and stage are used to determine treatment, current treatment resulting in more than 70% long-term survival. The extent of disease at diagnosis is the most important prognostic factor. Patients with localized disease have an excellent prognosis regardless of histology, with a 5-year survival rate of around 90%. The use of intensive multi-agent chemotherapy has improved the outcome for patients with more advanced disease. However, children who relapse after intensive treatment have a poor outcome despite aggressive attempts at salvage treatment. Future advances in treatment require multinational trials in order that treatment can be refined to reduce toxicity for those children with an expected good outcome, and to develop new strategies for children who relapse.