Prognostic Factors and Treatment Outcome of Relapsing and Refractory Pediatric Mature B-cell Non-Hodgkin Lymphoma, Children’s Cancer Hospital Egypt Experience

Author:

Semary Samah F.12ORCID,Abdel Rahman Hany23,Elkinaai Naglaa45,Zaky Iman67,Nagy Nouran8,Salem Sherine910,Hamoda Asmaa23

Affiliation:

1. Department of Clinical Oncology, Beni-Suef University, Beni-Suef, Egypt

2. Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt

3. Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt

4. Department of Pathology, Children Cancer Hospital Egypt, Cairo, Egypt

5. Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt

6. Department of Radiodiagnosis, Children Cancer Hospital Egypt, Cairo, Egypt

7. Department of Radiodiagnosis, National Cancer Institute, Cairo University, Cairo, Egypt

8. Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt

9. Department of Clinical Pathology, Children Cancer Hospital Egypt, Cairo, Egypt

10. Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt

Abstract

Background: Relapsed non-Hodgkin lymphoma treated by chemotherapy and hematopoietic stem cell transplantation (HSCT) has a dismal prognosis. Patients: It is a retrospective study, including pediatric patients diagnosed as mature B-cell non-Hodgkin lymphoma who were primarily refractory or relapsed over 8 years at CCHE. The aim of the study was to analyze the prognostic factors and outcomes of this group of patients. Our result is, 53 of 750 (7%) patients were included. Thirty-four (64.2%) patients had Burkitt lymphoma. Forty-eight (90.6%) patients received LMB 96 protocol initially. The median delay of duration between chemotherapy cycles in first-line treatment was 37 days. Thirty-five (66%) patients relapsed, 23 (65.7%) of them relapsed early, whereas 18 (34%) had tumor progression. Thirty-one (58.5%) patients presented with stage IV at the time of relapse. rituximab, ifosfamide, carboplatin, etoposide was the second line of treatment in 42 (79.24%) patients, and complete second remission was achieved only in 13 (24.3%) patients. Allogeneic HSCT was done for 4 (7.5%) patients, and auto HSCT was done for 3 (5.7%) patients. Three years of overall survival for relapsed and progressed patients were 35.3% and 11.1%, respectively, with a P-value of 0.009. Three years overall survival for patients who underwent HSCT was 85.7% compared with 18.1% for no HSCT with a P-value of 0.007. Conclusions: The relapse rate is higher than literatures because of the delay of duration between chemotherapy cycles in first-line treatment and more advanced stage at time of relapse. Progression of the disease had a worse outcome than relapse. HSCT in patients with the second remission markedly improved the outcome.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Oncology,Hematology,Pediatrics, Perinatology and Child Health

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