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儿童非霍奇金淋巴瘤免疫分型分为B细胞型和T细胞型。T细胞型对化疗反应差,容易复发和发生中枢神经系统白血病,化疗中应采取强化疗方案,延长化疗时间。化疗前基本放弃对原发灶的放疗。是否应用头颅预防性放疗目前仍有争议,大部分协作组建议用大剂量甲氨蝶呤、阿糖胞苷（Ara-c）及鞘内注射替代头颅放疗。目前对于Ⅰ、Ⅱ期的治疗方案仍有争议,进展期应用多种药物联合化疗方案。加用大剂量Ara-c、鬼臼乙叉甙和左旋门冬酰胺酶可提高无病生存率。骨髓复发的患儿应采取异体骨髓移植;B细胞型的治疗应早期强化治疗,短程疗法。Ⅰ、Ⅱ期治疗应减轻化疗,进展期应着重应用大剂量甲氨蝶呤、大剂量Ara-c、环磷酰胺等药物,化疗总剂量与预后明显相关。
Child non-Hodgkin’s lymphoma immune classification is divided into B cell type and T cell type. T cell type response to chemotherapy is poor, easy to relapse and the occurrence of central nervous system leukemia, chemotherapy should be intensive chemotherapy program to extend the chemotherapy time. Basically give up before chemotherapy on the primary tumor radiotherapy. It is still controversial whether to use cranial prophylactic radiotherapy. Most cooperative groups recommend using high-dose methotrexate, cytarabine (Ara-c) and intrathecal injection to replace cranial radiotherapy. At present, there are still controversial treatments for stage I and stage II, and advanced multi-drug combination chemotherapy regimens. Plus high doses of Ara-c, etoposide and L-asparaginase can improve disease-free survival rate. Bone marrow recurrence in children should be allogeneic bone marrow transplantation; B-cell therapy should be early intensive treatment, short-course therapy. Chemotherapy should be alleviated in the treatment of stage Ⅰ and Ⅱ, and high dose methotrexate, high dose Ara-c and cyclophosphamide should be emphasized in the advanced stage. The total dose of chemotherapy is obviously related to the prognosis.