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104例B细胞非霍奇金淋巴瘤患儿的治疗结果

[Outcomes of 104 children with B-cell non-Hodgkin lymphoma].

作者信息

Ye Qi-dong, Pan Ci, Xue Hui-liang, Chen Jing, Zhou Min, Jiang Hua, Shen Shu-hong, Tang Yan-jing, Wang Jian-min

机构信息

Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2013 May;34(5):399-403. doi: 10.3760/cma.j.issn.0253-2727.2013.05.005.

Abstract

OBJECTIVE

To analyze outcomes and prognostic factors of children with B-cell non-Hodgkin lymphoma (B-NHL).

METHODS

One hundred and four newly diagnosed B-NHL children were enrolled in protocol of B-NHL 2001. The statistics were performed by SPSS 13.0.

RESULTS

Of 104 children (79 males, the median age of 7.1 years), 60, 32 and 4 patients were diagnosed with Burkitt lymphoma, diffuse large B-cell lymphoma and unclassifiable B-cell lymphoma, respectively. Four patients were in stage Ⅰ, 27 stage Ⅱ, 55 stage Ⅲ and 18 stage Ⅳ; 1, 26 and 77 patients were allocated into R1, R2 and R3 risk groups, respectively. Three patients never got complete remission (CR), 9 patients relapsed after CR with the duration of relapse from 1 to 7 months after chemotherapy. The estimated 5-year EFS of 104 patients was (86.7 ± 3.5)%. Univariable analyses identified that risk factors for recurrence were of higher staging, elevated LDH, serum ferritin and poor early response. Age, sex, pathologic diagnosis, original tumor, bone or marrow involvement, C-MYC and risk group were not found to be associated with the risk of failure to treatment. Multivariable COX regression models confirmed serum ferritin as a significant independent prognostic marker.

CONCLUSION

B-NHL 2001 protocol was reasonable for B-NHL children. Higher staging, elevated LDH, serum ferritin and poor early response increased risk for recurrence.

摘要

目的

分析B细胞非霍奇金淋巴瘤(B-NHL)患儿的治疗结果及预后因素。

方法

104例新诊断的B-NHL患儿纳入B-NHL 2001方案。采用SPSS 13.0进行统计学分析。

结果

104例患儿(79例男性,中位年龄7.1岁)中,分别有60例、32例和4例被诊断为伯基特淋巴瘤、弥漫性大B细胞淋巴瘤和无法分类的B细胞淋巴瘤。4例为Ⅰ期,27例为Ⅱ期,55例为Ⅲ期,18例为Ⅳ期;分别有1例、26例和77例患儿被分配到R1、R2和R3风险组。3例患儿从未获得完全缓解(CR),9例患儿CR后复发,复发时间为化疗后1至7个月。104例患儿的5年无事件生存率估计为(86.7±3.5)%。单因素分析确定复发的危险因素为分期较高、乳酸脱氢酶(LDH)升高、血清铁蛋白升高和早期反应差。未发现年龄、性别、病理诊断、原发肿瘤、骨或骨髓受累、C-MYC和风险组与治疗失败风险相关。多因素COX回归模型证实血清铁蛋白是一个显著的独立预后标志物。

结论

B-NHL 2001方案对B-NHL患儿是合理的。分期较高、LDH升高、血清铁蛋白升高和早期反应差会增加复发风险。

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