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儿童和青少年外周T细胞淋巴瘤:单机构经验

Peripheral T-cell lymphoma in children and adolescents: a single-institution experience.

作者信息

Al Mahmoud Rabah, Weitzman Sheila, Schechter Tal, Ngan Bo, Abdelhaleem Mohammed, Alexander Sarah

机构信息

Department of Paediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

出版信息

J Pediatr Hematol Oncol. 2012 Nov;34(8):611-6. doi: 10.1097/MPH.0b013e3182707592.

Abstract

BACKGROUND

Peripheral T-cell lymphoma (PTCL) is rare in pediatric patients and is associated with worse outcome compared with other pediatric non-Hodgkin lymphomas. We report our institutional experience over a 10-year period.

METHODS

Patients were identified through the institutional oncology database. Data were abstracted through a detailed retrospective review of patient charts. Those with isolated cutaneous T-cell lymphoma were excluded from this analysis.

RESULTS

Thirteen patients were diagnosed with PTCL during the 10-year period. All presented with advanced disease. According to the WHO PTCL classification, 7 patients had PTCL not otherwise specified, 3 had hepatosplenic T-cell lymphoma and 3 had T-cell posttransplant lymphoproliferative disease. Six of the patients had previously received or were receiving immunosuppressive therapy at the time of their diagnosis. Patients were treated with various chemotherapeutic regimens, including B-cell non-Hodgkin lymphomas and T-cell acute lymphoblastic leukemia-like therapy. Patients who had refractory or recurrent disease were changed to alternative therapy. Eight patients underwent stem cell transplantation, 7 allogeneic and 1 autologous. Of the 13 patients, 7 died. Three patients died from disease progression, 3 died from treatment-related mortality, and 1 patient died from cardiac rejection. Six patients (46%) are alive and disease free at a median of 21 months (2 to 79 mo).

CONCLUSIONS

Children with PTCL have an unfavorable outcome. A standard approach to management of pediatric PTCL needs to be established to improve outcome. Because of the rarity of this condition, this will require collaborative studies.

摘要

背景

外周T细胞淋巴瘤(PTCL)在儿科患者中较为罕见,与其他儿科非霍奇金淋巴瘤相比,其预后较差。我们报告我们机构10年间的经验。

方法

通过机构肿瘤数据库识别患者。通过对患者病历进行详细的回顾性审查提取数据。孤立性皮肤T细胞淋巴瘤患者被排除在本分析之外。

结果

10年间有13例患者被诊断为PTCL。所有患者均表现为晚期疾病。根据世界卫生组织PTCL分类,7例为未另行特指的PTCL,3例为肝脾T细胞淋巴瘤,3例为移植后T细胞增殖性疾病。6例患者在诊断时曾接受或正在接受免疫抑制治疗。患者接受了各种化疗方案,包括B细胞非霍奇金淋巴瘤和T细胞急性淋巴细胞白血病样治疗。难治性或复发性疾病患者改为替代治疗。8例患者接受了干细胞移植,7例为异基因移植,1例为自体移植。13例患者中,7例死亡。3例死于疾病进展,3例死于治疗相关死亡率,1例死于心脏排斥反应。6例患者(46%)存活且无疾病,中位随访时间为21个月(2至79个月)。

结论

PTCL患儿预后不佳。需要建立一种标准的儿科PTCL管理方法以改善预后。由于这种疾病罕见,这将需要开展合作研究。

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