Zhonghua Er Ke Za Zhi. 2017 Mar 2;55(3):194-199. doi: 10.3760/cma.j.issn.0578-1310.2017.03.006.
To provide a descriptive review and improve our understanding of the clinical characteristics and treatment outcome of pediatric anaplastic large cell lymphoma (ALCL) in China. The clinical data and outcomes of patients under 16 years of age with newly histopathologically-confirmed ALCL in 10 large single institutions in China between January 2009 and June 2014, were retrospectively analyzed.The event-free survival (EFS) was analyzed by the Kaplan-Meier method.The risk factors of disease progression or relapse were evaluated by logistic regression analysis.Significance was defined as <0.05. Of the 80 eligible patients (52 male, 28 female), the median age was 8.4 years (range, 1.3-15.7 years). Two patients (3%) were Stage Ⅰ, 9(11%) Stage Ⅱ, 64 (80 %) Stage Ⅲ, and 5(6%) Stage Ⅳ.The median time of follow-up was 25.2 months (range, 7.1-74.8 months), 55 patients survived without disease at the last of follow-up, the 3-year EFS was (65±6)%. Sixty-five patients (81%) were treated with the Chinese Children Cancer Group-B cell-non-Hodgkin Lymphoma 2010 protocol, regimen and 15 cases (19%) were treated with other regimens.The 3-year EFS were (68±5)% .(65±20)% (=0.21). The 3-year EFS was (57±7)% and (78±11)% for patients with or without B symptoms (=0.01). Twenty-four patients experienced disease progression or relapse. The median time from initial diagnosis to tumor failure was 7.0 months (ranged, 1.5-42.6 months) (median). At the last evaluation, there were 5 patients still alive after disease progression and relapse. By univariate analysis, sex (=0.04) and B symptoms (=0.00) were identified as risk factors of disease progression or relapse.Nevertheless, only B symptoms ( 5.60, 95% 1.47-21.27, ≤0.05) were risk factors in multivariate analysis. The presenting features of children and adolescents with ALCL and efficiency in this study were similar to those reported by western countries.Refinement of therapeutic strategies to improve survival for patients with disease progression or relapse should be the priority in future clinical study.
目的是进行描述性综述,以增进我们对中国儿童间变性大细胞淋巴瘤(ALCL)临床特征及治疗结果的了解。回顾性分析了2009年1月至2014年6月期间中国10家大型单一机构中16岁以下新经组织病理学确诊为ALCL患者的临床资料及转归。采用Kaplan-Meier法分析无事件生存期(EFS)。通过逻辑回归分析评估疾病进展或复发的危险因素。显著性定义为<0.05。在80例符合条件的患者中(男性52例,女性28例),中位年龄为8.4岁(范围1.3 - 15.7岁)。2例(3%)为Ⅰ期,9例(11%)为Ⅱ期,64例(80%)为Ⅲ期,5例(6%)为Ⅳ期。中位随访时间为25.2个月(范围7.1 - 74.8个月),55例患者在末次随访时无疾病存活,3年EFS为(65±6)%。65例患者(81%)接受中国儿童癌症协作组 - B细胞非霍奇金淋巴瘤2010方案治疗,15例患者(19%)接受其他方案治疗。3年EFS分别为(68±5)%和(65±20)%(P = 0.21)。有或无B症状患者的3年EFS分别为(57±7)%和(78±11)%(P = 0.01)。24例患者出现疾病进展或复发。从初始诊断到肿瘤进展的中位时间为7.0个月(范围1.5 - 42.6个月)(中位)。在末次评估时,有5例患者在疾病进展和复发后仍存活。单因素分析显示,性别(P = 0.04)和B症状(P = 0.00)被确定为疾病进展或复发的危险因素。然而,多因素分析中仅B症状(5.60,95%置信区间1.47 - 21.27,P≤0.05)是危险因素。本研究中儿童和青少年ALCL的临床表现及疗效与西方国家报道的相似。未来临床研究应优先完善治疗策略,以提高疾病进展或复发患者的生存率。