The National Comprehensive Cancer Network® (NCCN®) has published new guidelines for treating children, adolescents, and young adults with pediatric aggressive mature B-cell lymphomas, including Burkitt lymphoma and diffuse large B-cell lymphoma. NCCN published the first pediatric NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) in 2019 that addressed acute lymphoblastic leukemia. These new pediatric guidelines—with more to follow—further NCCN’s efforts to improve quality of care and outcomes for children with cancer worldwide.
Historically, most children with cancer in the United States have been included on active clinical trials, with clear protocols in place to standardize treatment and maximize response while addressing potential toxicities. However, improved cure rates and decreased research funding have resulted in more patients being treated outside of clinical trials, where treatment guidelines are lacking. The new NCCN Guidelines are intended to fill the void and ensure that management is provided in the best possible manner to improve both short- and long-term outcomes. Furthermore, globally (especially in resource-constrained settings) many patients do not have access to oncologists who specialize in pediatric cancers, making guidelines highly relevant for these situations.
Non-Hodgkin lymphoma is responsible for approximately 5% of all cancers in children aged 14 and younger and 7% of all cancers for adolescents between 15 and 19 years old.1 Major supportive care concerns include disease-associated infections, renal dysfunction, bowel obstruction, treatment-related tumor-lysis syndrome, neurotoxicity, and mucositis.2
The NCCN plans to adapt these guidelines into NCCN Harmonized Guidelines™ for Sub-Saharan Africa, which take into account specific regional concerns and potential resource limitations. The organization will also continue expanding into pediatric recommendations with upcoming NCCN Guidelines for Wilms Tumor and Pediatric Hodgkin Lymphoma. Recently, the NCCN also published new supportive care guidelines detailing best practices before and after stem cell transplantation and significantly updated the NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic.
All NCCN Guidelines can be viewed and downloaded free-of-charge for noncommercial use at NCCN.org or via the NCCN Guidelines® app.■
1. Siegel RL, Miller KD, Jemal A: Cancer statistics, 2019. CA Cancer J Clin 69:7-34, 2019.
2. Cairo MS, Coiffier B, Reiter A, et al: Recommendations for the evaluation of risk and prophylaxis of tumour lysis syndrome (TLS) in adults and children with malignant diseases: An expert TLS panel consensus. Br J Haematol 149:578-586, 2010.