Research into the biology and treatment of pediatric lymphomas is directed towards the development of improved treatment strategies. and has both short term and long term goals. The primary short term goals include increasing the therapeutic index of combination chemotherapy regimens and continuing to characterize prognostic factors and patterns of disease relevant to treatment approaches. The primary long term goal is to develop a detailed understanding of the pathogenetic mechanisms of the non-Hodgkin's lymphomas, with particular emphasis on the small cleaved lymphomas, with the ultimate goal of utilizing this information in the development of novel treatment approaches. 105 patients with non-Hodgkin's lymphoma have been treated according to PB protocol 77-C-145. This protocol has produced a wealth of information regarding prognostic factors, patterns of disease, and the apparent lack of a role for radiation therapy in all patients except, possibly, those presenting with testicular lymphoma. In addition, tumor samples collected from patients treated with this protocol have provided a unique library of cell lines which have been invaluable both to ourselves and to many other laboratories in the study of the biology and molecular genetics of the small non-cleaved lymphomas. Ongoing studies are directed towards the identification of the pathogenetic role of EBV, the pathogenetic and clinical significance of chromosomal breakpoint locations, and attempts to develop a means of specifically inhibiting the expression of the c-myc oncogene in Burkitt's lymphoma. Pilot protocols have provided toxicity information on a modified and considerably curtailed version of protocol 77-C-145 and identified a new, effective drug combination now ready to be incorporated into primary therapy.
