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Testicular Disease in Childhood B-Cell Non-Hodgkin’s Lymphoma: The French Society of Pediatric Oncology Experience

From Service d’Oncologie Pédiatrique and Département d’Oncologie Pédiatrique, Institut Gustave Roussy, Villejuif; Unité d’Oncologie et Hématologie Pédiatrique, Centre Hospitalier Universitaire de Nantes, Nantes; Département d’Oncologie Pédiatrique, Institut Curie, Paris; Unité d’Oncologie et Hématologie Pédiatrique, Centre Hospitalier Universitaire de Marseille, Marseille; Unité d’Oncologie et Hématologie Pédiatrique, CHU de Limoges, Limoges; Unité d’Oncologie et Hématologie Pédiatrique, CHU de Toulouse, Toulouse; and Unité d’Oncologie et Hématologie Pédiatrique, CHU de Nancy, Nancy, France.

Address reprint requests to Jean-Hugues Dalle, MD, Service des Maladies du Sang, Unité de greffe de moelle, Centre Hospitalier Regional Universitaire de Lille, 59037 Lille Cedex, France; email: jhdalle{at}wanadoo.fr

PURPOSE: To investigate whether testicular disease in childhood B-cell lymphoma should continue to be considered a sanctuary site, as it is with other lymphoid malignancies such as acute lymphoblastic leukemia.

PATIENTS AND METHODS: Seven hundred forty-two children with B-cell non-Hodgkin’s lymphoma were included in the LMB protocols of the French Society of Pediatric Oncology from February 1981 to May 1994. Thirty patients (5.3%) had testicular involvement at diagnosis. We describe the clinical presentation and outcome of these 30 patients, who were treated without local radiation therapy.

RESULTS: Five patients underwent diagnostic orchidectomy. The median patient age was 8.5 years (range, 2 to 14 years), and their cancers were stage III (18 patients), stage IV (five patients), and B-cell acute lymphoblastic leukemia (seven patients). Five patients had central nervous system involvement. Twenty-eight patients (95%) achieved complete remission. Twenty-six patients are alive without progressive disease (median follow-up, 6.5 years).

CONCLUSION: Testicular disease does not seem to confer a poor prognosis, and it is curable with intensive combination chemotherapy alone. Local treatment (surgery or radiation) is avoidable; therefore, gonadal function can be preserved.

Presented in part at the Thirty-First Annual Meeting of The American Society of Clinical Oncology, Los Angeles, CA, May 21-23, 1995.

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