We analyzed children and adolescents with PMBCL confirmed by central histopathological review, excluding mediastinal grey zone lymphoma, enrolled in the B04 trial (German clinical trial registry, DRKS00009436) or the NHL-BFM Registry 2012 between 2004 and 2019 to assess the efficacy of intensified B-NHL-BFM chemotherapy (n=29 patients) and modified DA-EPOCH-R (n=67 patients), compare it retrospectively to the treatment regimen in the NHL-BFM 95 trial (N95, n=20 patients) and to identify risk factors for treatment failure with DA-EPOCH-R.