Fadoo Zehra, Belgaumi Asim, Alam Matloob, Azam Iqbal, Naqvi Ahmed
Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.
J Pediatr Hematol Oncol. 2010 Jan;32(1):e14-8. doi: 10.1097/MPH.0b013e3181bdf1f3.
Lymphoma is the third most common childhood malignancy. Less information is available on this disease and its outcome from our country. We present here a single institute experience. A retrospective study was carried out at Aga Khan University Hospital, Karachi on children (<15 y) diagnosed with lymphoma from 1998 to 2007. Sixty-eight patients were identified. Fifty-one children were diagnosed as non-Hodgkin lymphoma (NHL). Mean age of presentation was 8.4 years with male-to-female ratio of 5.8 : 1. Most common histopathologic subtype of NHL was Burkitt lymphoma (55%). Abdominal mass was the main presenting feature of Burkitt and diffuse large B cell lymphoma. T-lymphoblastic lymphoma presented mainly as mediastinal mass. Ten children died, 4 secondary to tumor lysis syndrome, 5 because of disease progression, and 1 with chemotherapy-induced toxicity. One-third of the patients left without treatment. Seventeen children were diagnosed as Hodgkin lymphoma with mixed cellularity as the commonest subtype (65%). Overall survival of children with NHL and Hodgkin lymphoma was 62% and 94%, respectively. A greater proportion of NHL, advanced stage, and profound male preponderance were observed. Improvement in survival can only be achieved with increasing awareness, identifying and tackling causes of abandonment, early referral, and better supportive care.
淋巴瘤是儿童期第三大常见恶性肿瘤。我国关于这种疾病及其预后的信息较少。我们在此呈现一家机构的经验。对1998年至2007年在卡拉奇阿迦汗大学医院诊断为淋巴瘤的15岁以下儿童进行了一项回顾性研究。共确定了68例患者。51名儿童被诊断为非霍奇金淋巴瘤（NHL）。就诊时的平均年龄为8.4岁，男女比例为5.8∶1。NHL最常见的组织病理学亚型是伯基特淋巴瘤（55%）。腹部肿块是伯基特淋巴瘤和弥漫性大B细胞淋巴瘤的主要就诊特征。T淋巴母细胞淋巴瘤主要表现为纵隔肿块。10名儿童死亡，4例死于肿瘤溶解综合征，5例死于疾病进展，1例死于化疗引起的毒性反应。三分之一的患者未接受治疗就离开了。17名儿童被诊断为霍奇金淋巴瘤，最常见的亚型是混合细胞型（65%）。NHL和霍奇金淋巴瘤患儿的总生存率分别为62%和94%。观察到NHL比例更高、分期更晚且男性占比极高。只有通过提高认识、识别并解决放弃治疗的原因、早期转诊以及更好的支持性护理，才能提高生存率。
