Progress against non-Hodgkin's lymphoma in children and young adolescents in the Netherlands since 1990: Stable incidence, improved survival and lower mortality

Ardine M.J. Reedijk, Auke Beishuizen, Jan Willem W. Coebergh, Bianca A.W. Hoeben, Leontien C.M. Kremer, Konnie M. Hebeda, Rob Pieters, Jan L.C. Loeffen, Henrike E. Karim-Kos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: With epidemiologic analyses of population-based trends in incidence and outcomes, we ascertained progress against non-Hodgkin's lymphoma (NHL) in children and young adolescents in the Netherlands since 1990. Methods: Tumour characteristics were extracted from the Netherlands Cancer Registry for patients aged <18 years at diagnosis, between 1990 and 2015. Mortality data for 1980–2016 were derived from Statistics Netherlands. NHL subtypes comprised lymphoblastic lymphoma (LBL), Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) and anaplastic large cell lymphoma (ALCL). Time trends in incidence and mortality rates and 5-year overall survival (OS) rates were evaluated by average annual percentage change (AAPC) analyses and parametric survival models, respectively. Results: Overall incidence of NHL remained stable at 11 per million person-years (AAPC -0.2%, p = 0.68), with a marked decrease among children of 5–9 years (AAPC -2.6%, p < 0.01), especially among those with BL. Treatment regimens comprised less radiotherapy over time, especially for LBL and BL. Since 2004, most 15–17-year-old patients with NHL have been treated at a paediatric oncology centre. Five-year OS improved from 71% in 1990–94 to 87% in 2010–15 (p < 0.01), the most gain has been achieved in patients with DLBCL and ALCL from 60% and 73%, respectively, to both 90%. Population-based mortality from NHL decreased significantly towards 1.4 per million person-years (AAPC -4.2%, p < 0.01). Conclusions: This population-based epidemiological study exhibited significant progress against childhood and young adolescent NHL in the Netherlands since 1990, before the advent of a national paediatric oncologic centre in 2018: incidence decreased among children of 5–9 years, survival improved, and mortality steadily decreased over time.

Original languageEnglish
Pages (from-to)140-151
Number of pages12
JournalEuropean Journal of Cancer
Volume163
Early online date21 Jan 2022
DOIs
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
The authors would like to thank KiKa and VIOZ for funding this study and the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL) for the thorough collection, quality control and storage of data for the Netherlands Cancer Registry.

Funding Information:
The present work was funded by the Stichting Kinderen Kankervrij (KiKa) [project number 207] and by the Steunfonds Vrienden Integrale Oncologische Zorg (VIOZ). The funding sources had no role in the study design, data collection, analyses and interpretation of the results, nor in the writing of this article and the decision to submit the article for publication.

Publisher Copyright:
© 2021 The Authors

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