Chen Zai-Sheng, Zheng Yong-Zhi, Chen Yi-Qiao, Gao Qin-Li, Li Jian, Shen Jian-Zhen
Fujian Institute of Hematology/Fujian Provincial Key Laboratory on Hematology/Fujian Medical University Union Hospital, Fuzhou 350001, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jun;20(6):470-474. doi: 10.7499/j.issn.1008-8830.2018.06.008.
To study the clinical features and treatment outcome of children with mature B-cell non-Hodgkin's lymphoma (B-NHL).
A total of 28 previously untreated children with mature B-NHL were enrolled and given the chemotherapy regimen of CCCG-B-NHL-2010. Among them, 20 were given rituximab in addition to chemotherapy. The children were followed up for 31 months (ranged 4-70 months). A retrospective analysis was performed for the clinical features of these children. The Kaplan-Meier method was used for survival analysis. A univariate analysis was performed to investigate the prognostic factors.
Among the 28 children, 17 (61%) had Burkitt lymphoma, 8 (29%) had diffuse large B-cell lymphoma (DLBCL), and 3 (11%) had unclassifiable B-cell lymphoma. As for the initial symptom, 13 (46%) had cervical mass, 10 (36%) had maxillofacial mass, 9 (32%) had hepatosplenomegaly, 5 (18%) had abdominal mass, and 5 (18%) had exophthalmos. Of all children, 14 had a lactate dehydrogenase (LDH) level of <500 IU/L, 3 had a level of 500-1 000 IU/L, and 11 had a level of ≥ 1 000 IU/L. After two courses of chemotherapy, 21 children achieved complete remission and 7 achieved partial remission. At the end of follow-up, 24 achieved continuous complete remission and 4 experienced recurrence. The 2-year event-free survival rate was (85.7± 6.6)%. The children with bone marrow infiltration suggested by bone marrow biopsy, serum LDH ≥500 IU/L, and bone marrow tumor cells >25% had a low 2-year cumulative survival rate.
The CCCG-B-NHL 2010 chemotherapy regimen combined with rituximab has a satisfactory effect in the treatment of children with B-NHL. Bone marrow infiltration on bone marrow biopsy is associated with poor prognosis.
研究成熟B细胞非霍奇金淋巴瘤（B-NHL）患儿的临床特征及治疗效果。
共纳入28例初治的成熟B-NHL患儿，给予CCCG-B-NHL-2010化疗方案。其中20例在化疗基础上加用利妥昔单抗。对患儿进行31个月（4 - 70个月）的随访。对这些患儿的临床特征进行回顾性分析。采用Kaplan-Meier法进行生存分析。进行单因素分析以探讨预后因素。
28例患儿中，17例（61%）为伯基特淋巴瘤，8例（29%）为弥漫性大B细胞淋巴瘤（DLBCL），3例（11%）为无法分类的B细胞淋巴瘤。初始症状方面，13例（46%）有颈部肿块，10例（36%）有颌面肿块，9例（32%）有肝脾肿大，5例（18%）有腹部肿块，5例（18%）有眼球突出。所有患儿中，14例乳酸脱氢酶（LDH）水平<500 IU/L，3例水平为500 - 1000 IU/L，11例水平≥1000 IU/L。两疗程化疗后，21例患儿达到完全缓解，7例达到部分缓解。随访结束时，24例持续完全缓解，4例复发。2年无事件生存率为（(85.7\pm 6.6)）%。骨髓活检提示骨髓浸润、血清LDH≥500 IU/L且骨髓肿瘤细胞>25%的患儿2年累积生存率较低。
CCCG-B-NHL 2010化疗方案联合利妥昔单抗治疗B-NHL患儿效果满意。骨髓活检提示骨髓浸润与预后不良相关。
