Rjeib Hamid D Habeeb, Al-Jumaily Usama, Ali Inas Muayad Mohammed, Faraj Safa, Al-Qanbar Mohammed Fawzi, Al-Khateeb Dheyaa Aldeen, Jabbar Shaima
Department.of Pathology, College of Medicine, University of Al-Qadisiyah, Al-Qadisiyah, Iraq.
Al-Subtain University of Medical Sciences/TUMS, Karbala, Iraq.
Leuk Res Rep. 2025 Jul 23;24:100531. doi: 10.1016/j.lrr.2025.100531. eCollection 2025.
Mature B-cell non-Hodgkin lymphoma (B-NHL) is a prevalent pediatric malignancy with significant treatment advancements. This study retrospectively analyzes clinical characteristics, treatment outcomes, and survival rates of children and adolescents diagnosed with B-NHL at Al-Hasan Al-Mojtaba Hospital between January 2014 and December 2024. A comparative analysis was performed between the LMB96 and R-CHOP regimens.
Patients with confirmed diagnoses of Large B-cell lymphoma or Burkitt's lymphoma, based on WHO classification criteria, were included. Staging was conducted using the St. Jude system, and risk classification followed the FAB/LMB criteria. Treatment involved a modified LMB96 regimen, later replaced by R-CHOP in the last two years of the study. Event-free survival (EFS) was analyzed using Kaplan-Meier survival curves, with stratifications by staging, risk group, and gender.
A total of 66 patients were included (median age: 5.8 years; 69.7 % male). Burkitt's lymphoma was the predominant histology (86.3 %). The abdomen was the most common primary site (84.8 %). The majority of patients (72.7 %) presented with advanced-stage disease (Stages III and IV). Risk group classification identified 62.1 % of patients in Group B and 28.8 % in Group C. Kaplan-Meier survival analysis revealed Group A had the most favorable prognosis (EFS ∼100 %), followed by Group B (∼75 %), and Group C (∼50 %). Disease stage significantly influenced survival ( = 0.021), with Stage IV patients demonstrating the poorest outcomes. While female patients exhibited higher EFS than males, the difference was not statistically significant ( = 0.27). By the end of follow-up, 28.8 % of patients had experienced a fatal outcome.
Advanced-stage B-NHL remains prevalent, with significant survival differences based on staging and risk classification. The transition from LMB96 to R-CHOP warrants further evaluation to optimize pediatric treatment strategies. Larger studies are needed to validate observed gender-based survival trends.
成熟B细胞非霍奇金淋巴瘤（B-NHL）是一种常见的儿科恶性肿瘤，治疗有了显著进展。本研究回顾性分析了2014年1月至2024年12月期间在哈桑·穆贾塔巴医院被诊断为B-NHL的儿童和青少年的临床特征、治疗结果和生存率。对LMB96和R-CHOP方案进行了比较分析。
纳入根据世界卫生组织分类标准确诊为大B细胞淋巴瘤或伯基特淋巴瘤的患者。采用圣裘德系统进行分期，风险分类遵循FAB/LMB标准。治疗采用改良的LMB96方案，在研究的最后两年改为R-CHOP方案。使用Kaplan-Meier生存曲线分析无事件生存期（EFS），并按分期、风险组和性别进行分层。
共纳入66例患者（中位年龄：5.8岁；69.7%为男性）。伯基特淋巴瘤是主要的组织学类型（86.3%）。腹部是最常见的原发部位（84.8%）。大多数患者（72.7%）表现为晚期疾病（III期和IV期）。风险组分类显示62.1%的患者为B组，28.8%为C组。Kaplan-Meier生存分析显示A组预后最佳（EFS约100%），其次是B组（约75%）和C组（约50%）。疾病分期对生存率有显著影响（P = 0.021），IV期患者预后最差。虽然女性患者的EFS高于男性，但差异无统计学意义（P = 0.27）。随访结束时，28.8%的患者出现了致命结局。
晚期B-NHL仍然普遍，基于分期和风险分类存在显著的生存差异。从LMB96到R-CHOP的转变值得进一步评估，以优化儿科治疗策略。需要更大规模的研究来验证观察到的基于性别的生存趋势。
