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儿童和青少年淋巴细胞性淋巴瘤的预后。

Outcome of children and adolescents with lymphoblastic lymphoma.

作者信息

Oliveira Maria Christina Lopes Araújo, Sampaio Keyla Christy, Oliveira Aline Carneiro, Santos Aieska Dantas, Castro Lúcia Porto, Viana Marcos Borato

机构信息

Hematology Division, Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2015 Sep-Oct;61(5):417-22. doi: 10.1590/1806-9282.61.05.417.

Abstract

INTRODUCTION

lymphoblastic lymphoma (LBL) is the second most common subtype of non-Hodgkin lymphoma in children. The aim of this study was to characterize the clinical course of children and adolescents with LBL treated at a tertiary center.

METHODS

this is a retrospective cohort study of 27 patients aged 16 years or younger with LBL admitted between January 1981 and December 2013. Patients were treated according to the therapy protocol used for acute lymphoblastic leucemia. Diagnosis was based on biopsy of tumor and/or cytological examination of pleural effusions. The overall survival was analyzed using the Kaplan-Meier method.

RESULTS

the median age at diagnosis was 11.6 years (interquartile range, 4.6- 13.8). LBL had T-cell origin in 16 patients (59%). The most common primary manifestation in T-cell LBL was mediastinal involvement, in 9 patients (56%). Intra-abdominal tumor was the major site of involvement in patients with precursor B-LBL. Most patients had advanced disease (18 patients - 67%) at diagnosis. Twenty-four patients (89%) achieved complete clinical remission. After a median follow-up of 43 months (interquartile range, 6.4-95), 22 patients (81%) were alive in first complete remission. Five children (18.5%) died, three of them soon after admission and two after relapsing. The probability of survival at five years for 20 patients with de novo LBL was 78% (SD 9.4).

CONCLUSION

our findings confirm the favorable prognosis of children with LBL with an intensive chemotherapy regimen derived from ALL therapy.

摘要

引言

淋巴母细胞淋巴瘤(LBL)是儿童非霍奇金淋巴瘤中第二常见的亚型。本研究的目的是描述在一家三级医疗中心接受治疗的儿童和青少年LBL患者的临床病程。

方法

这是一项回顾性队列研究,研究对象为1981年1月至2013年12月期间收治的27例16岁及以下的LBL患者。患者按照急性淋巴细胞白血病的治疗方案进行治疗。诊断基于肿瘤活检和/或胸腔积液的细胞学检查。采用Kaplan-Meier法分析总生存率。

结果

诊断时的中位年龄为11.6岁(四分位间距,4.6 - 13.8)。16例患者(59%)的LBL起源于T细胞。T细胞LBL最常见的主要表现是纵隔受累,9例患者(56%)出现该情况。腹腔内肿瘤是前体B-LBL患者的主要受累部位。大多数患者在诊断时处于晚期疾病(18例患者 - 67%)。24例患者(89%)实现了完全临床缓解。中位随访43个月(四分位间距,6.4 - 95)后,22例患者(81%)处于首次完全缓解状态存活。5名儿童(18.5%)死亡,其中3例在入院后不久死亡,2例在复发后死亡。20例初发LBL患者的5年生存率为78%(标准差9.4)。

结论

我们的研究结果证实,采用源自ALL治疗的强化化疗方案治疗的LBL儿童预后良好。

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