Araştırma Makalesi
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Hodgkin dışı lenfomalı çocukların klinik özelliklerinin, tedavi yaklaşımlarının ve tedavi sonuçlarının değerlendirilmesi

Yıl 2022, , 989 - 996, 30.11.2022
https://doi.org/10.16899/jcm.1202662

Öz

Amaç: Klinimizde, non-Hodgkin lenfoma tanısı konulan ve tedavi edilen çocuk hastalarımızın demografik ve klinik özelliklerini, tedavi yaklaşımlarını ve sonuçlarını değerlendirmektir.
Gereç ve Yöntem: 2006-2002 yılları arasında non-Hodgkin lenfoma tanısı alan ve takip edilen hastaların onkolojik dosyaları geriye dönük olarak incelendi.
Bulgular: Bu çalışmaya Hodgkin dışı lenfomalı seksen çocuk dahil edildi. Elli beş erkek (%68,8) ve 25 kız (%31,2) vardı. Hastaların yaşları 2 ile 18 yıl arasında değişmekteydi (ortanca: 11,1 yıl). Dokuz hastada (%11,3) primer immün yetmezlik vardı. Hastaların 63'ü evre III (%78,7) idi. Çoğunluk patolojik alt tip Burkitt lenfoma idi (n: 31, %38,8). Genel sağkalım ve olaysız sağkalım oranları sırasıyla %71,7 ve %71,5 idi. Primer immün yetmezliği olmayan ve olan hastaların genel sağkalım oranları sırasıyla %81,1 ve %11,1 idi. Bu iki grup arasında anlamlı bir fark vardı. Cox regresyon analizi, ileri evre ve eşlik eden primer immün yetmezliğin prognoz için risk faktörleri olduğunu göstermiştir.
Sonuç: Yoğun tedavi yaklaşımları, Hodgkin olmayan lenfoma olan çocuklarda genel sağkalım oranlarını artırmıştır. Ancak primer immün yetmezliği olan non-Hodgkin lenfoma çocuklarında bu başarı oranı elde edilememektedir.

Destekleyen Kurum

Yok

Kaynakça

  • 1. Huang MS, Weinstein HJ. Non-Hodgkin lymphoma. In: Fish JD, Lipton JM, Lanzkowsky P, editors, Lanzkowsky’s Manual of Pediatric Hematology and Oncology. San Diego: Academic Press; 2022. p. 473-83. https://doi.org/10.1016/C2019-0-03654-0
  • 2. Minard-Colin V, Patte C. Non-Hodgkin lymphomas in children and adolescents. In: Caron HN, Biondi A, Boterberg T, Doz F, editors. Oxford Textbook of Cancer in Children., Oxford: Oxford University Press; 2020. p. 142-56. https://doi.org/10.1093/med/9780198797210.001.0001
  • 3. Pillon M, Xavier AC, Cairo MS. Prognostic factors in childhood and ddolescent non-Hodgkin lymphoma. In: Abla O, Attarbaschi A, editors. Non-Hodgkin's Lymphoma in Childhood and Adolescence. Cham: Springer; 2019. p.131-49. https://doi.org/10.1007/978-3-030-11769-6_11
  • 4. Fish JD, Lipton JM, Lanzkowsky P. In: Fish JD, Lipton JM, Lanzkowsky P, editors, Lanzkowsky’s Manual of Pediatric Hematology and Oncology. San Diego: Academic Press; 2022. p. 767-80. https://doi.org/10.1016/C2019-0-03654-0
  • 5. Tezol O, Bozlu G, Sagcan F, Tuncel Daloglu F, Citak C. Value of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width in distinguishing between reactive lymphadenopathy and lymphoma in children. Bratisl Lek Listy. 2020; 121(4): 287-92. https://doi.org/10.4149/BLL_2020_045
  • 6. Woessmann W, Seidemann K, Mann G, et al. The impact of the methotrexate administration schedule and dose in the treatment of children and adolescents with B-cell neoplasms: a report of the BFM Group Study NHL-BFM95. Blood. 2005; 105(3):948-58. https://doi.org/10.1182/blood-2004-03-0973
  • 7. Reiter A, Schrappe M, Ludwig WD, et al. Intensive ALL-type therapy without local radiotherapy provides a 90% event-free survival for children with T-cell lymphoblastic lymphoma: a BFM group report. Blood. 2000; 95(2):416-21. https://doi.org/10.1182/blood.V95.2.416
  • 8. Patte C, Auperin A, Michon J, et al. The Société Française d'Oncologie Pédiatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood. 2001; 97(11): 3370-3379. https://doi.org/10.1182/blood.v97.11.3370
  • 9. Kara B, Gungorer V, Akyurek FT, Koksal Y. Stevens-Johnson syndrome and toxic epidermal necrolysis in children with non-Hodgkin lymphoma. J Pediatr Hematol Oncol. 2020;42(5):e310-e314. doi: 10.1097/MPH.0000000000001851. PMID: 32576784.
  • 10. Aydin B, Akyuz C, Kalkan N, et al. FAB LMB 96 regimen for newly diagnosed Burkitt lymphoma in children: Single-center experience. J Pediatr Hematol Oncol. 2019;41(1):e7-e11. doi: 10.1097/MPH.0000000000001270. PMID: 30059355.
  • 11. Ataş E, Kutluk MT, Akyüz C, et al. Clinical features and treatment results in children with anaplastic large cell lymphoma. Turk J Pediatr. 2015;57(5):458-66. PMID: 27411412.
  • 12. Ataş E, Kutluk MT, Akyüz C, et al. Clinical features and treatment results of children with diffuse large B-cell lymphoma. Pediatr Hematol Oncol. 2014;31(6):509-17. doi:10.3109/08880018.2014.940434
  • 13. Jan S, Mustafa O, Elgaml A, Ahmad N, Abbas A, Althubaiti S. Neutrophil-to-lymphocyte ratio and ferritin as measurable tools for disease burden and B symptoms in pediatric patients with Hodgkin Lymphoma. J Pediatr Hematol Oncol. 2022;44(2):e567-e571. doi:10.1097/MPH.0000000000002346. PMID: 34654761.
  • 14. Ertan K, Dogru A, Kara B, Koksal Y. Impact on the survival of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio on prognosis in children with Hodgkin lymphoma. Saudi Med J. 2022;43(5):451-457. doi: 10.15537/smj.2022.43.5.20210916

Evaluation of clinical features, treatment approaches and treatment outcomes of children with non-Hodgkin lymphoma

Yıl 2022, , 989 - 996, 30.11.2022
https://doi.org/10.16899/jcm.1202662

Öz

Aim: To evaluate the demographic and clinical characteristics, treatment approaches and outcomes of our pediatric patients with non-Hodgkin lymphoma diagnosed and treated in our center.
Material and Methods: Between 2006 and 2002, the oncologic charts of the patients diagnosed and followed up as non-Hodgkin lymphoma were reviewed retrospectively.
Results: Eighty children with non-Hodgkin lymphoma were included in this study. There were 55 boys (68.8%) and 25 girls (31.2%). The patients’ ages ranged from 2 to 18 years (median: 11.1 years). Nine patients (11.3%) had primary immunodeficiency. Sixty-three of the patients were stage III (78.7%). The majority pathologic subtype was Burkitt lymphoma (n: 31, 38.8%). The overall survival and event-free survival rates were 71.7% and 71.5%, respectively. The patients’ overall survival rates without and with primary immunodeficiency was 81.1% and 11.1%, respectively. There was a significant difference between these two groups. Cox regression analysis showed that advanced stage and concomitant primary immunodeficiency have been risk factors for prognosis.
Conclusion: Intensive treatment approaches have increased overall survival rates in children with non-Hodgkin lymphoma. However, this success rate cannot be achieved in non-Hodgkin lymphoma children with primary immunodeficiency.

Kaynakça

  • 1. Huang MS, Weinstein HJ. Non-Hodgkin lymphoma. In: Fish JD, Lipton JM, Lanzkowsky P, editors, Lanzkowsky’s Manual of Pediatric Hematology and Oncology. San Diego: Academic Press; 2022. p. 473-83. https://doi.org/10.1016/C2019-0-03654-0
  • 2. Minard-Colin V, Patte C. Non-Hodgkin lymphomas in children and adolescents. In: Caron HN, Biondi A, Boterberg T, Doz F, editors. Oxford Textbook of Cancer in Children., Oxford: Oxford University Press; 2020. p. 142-56. https://doi.org/10.1093/med/9780198797210.001.0001
  • 3. Pillon M, Xavier AC, Cairo MS. Prognostic factors in childhood and ddolescent non-Hodgkin lymphoma. In: Abla O, Attarbaschi A, editors. Non-Hodgkin's Lymphoma in Childhood and Adolescence. Cham: Springer; 2019. p.131-49. https://doi.org/10.1007/978-3-030-11769-6_11
  • 4. Fish JD, Lipton JM, Lanzkowsky P. In: Fish JD, Lipton JM, Lanzkowsky P, editors, Lanzkowsky’s Manual of Pediatric Hematology and Oncology. San Diego: Academic Press; 2022. p. 767-80. https://doi.org/10.1016/C2019-0-03654-0
  • 5. Tezol O, Bozlu G, Sagcan F, Tuncel Daloglu F, Citak C. Value of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width in distinguishing between reactive lymphadenopathy and lymphoma in children. Bratisl Lek Listy. 2020; 121(4): 287-92. https://doi.org/10.4149/BLL_2020_045
  • 6. Woessmann W, Seidemann K, Mann G, et al. The impact of the methotrexate administration schedule and dose in the treatment of children and adolescents with B-cell neoplasms: a report of the BFM Group Study NHL-BFM95. Blood. 2005; 105(3):948-58. https://doi.org/10.1182/blood-2004-03-0973
  • 7. Reiter A, Schrappe M, Ludwig WD, et al. Intensive ALL-type therapy without local radiotherapy provides a 90% event-free survival for children with T-cell lymphoblastic lymphoma: a BFM group report. Blood. 2000; 95(2):416-21. https://doi.org/10.1182/blood.V95.2.416
  • 8. Patte C, Auperin A, Michon J, et al. The Société Française d'Oncologie Pédiatrique LMB89 protocol: highly effective multiagent chemotherapy tailored to the tumor burden and initial response in 561 unselected children with B-cell lymphomas and L3 leukemia. Blood. 2001; 97(11): 3370-3379. https://doi.org/10.1182/blood.v97.11.3370
  • 9. Kara B, Gungorer V, Akyurek FT, Koksal Y. Stevens-Johnson syndrome and toxic epidermal necrolysis in children with non-Hodgkin lymphoma. J Pediatr Hematol Oncol. 2020;42(5):e310-e314. doi: 10.1097/MPH.0000000000001851. PMID: 32576784.
  • 10. Aydin B, Akyuz C, Kalkan N, et al. FAB LMB 96 regimen for newly diagnosed Burkitt lymphoma in children: Single-center experience. J Pediatr Hematol Oncol. 2019;41(1):e7-e11. doi: 10.1097/MPH.0000000000001270. PMID: 30059355.
  • 11. Ataş E, Kutluk MT, Akyüz C, et al. Clinical features and treatment results in children with anaplastic large cell lymphoma. Turk J Pediatr. 2015;57(5):458-66. PMID: 27411412.
  • 12. Ataş E, Kutluk MT, Akyüz C, et al. Clinical features and treatment results of children with diffuse large B-cell lymphoma. Pediatr Hematol Oncol. 2014;31(6):509-17. doi:10.3109/08880018.2014.940434
  • 13. Jan S, Mustafa O, Elgaml A, Ahmad N, Abbas A, Althubaiti S. Neutrophil-to-lymphocyte ratio and ferritin as measurable tools for disease burden and B symptoms in pediatric patients with Hodgkin Lymphoma. J Pediatr Hematol Oncol. 2022;44(2):e567-e571. doi:10.1097/MPH.0000000000002346. PMID: 34654761.
  • 14. Ertan K, Dogru A, Kara B, Koksal Y. Impact on the survival of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio on prognosis in children with Hodgkin lymphoma. Saudi Med J. 2022;43(5):451-457. doi: 10.15537/smj.2022.43.5.20210916
Toplam 14 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Buket Kara 0000-0003-4737-1901

Serdar Uğraş 0000-0003-0108-697X

Kübra Ertan 0000-0002-9981-8413

Yavuz Köksal 0000-0002-9190-7817

Yayımlanma Tarihi 30 Kasım 2022
Kabul Tarihi 24 Kasım 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

AMA Kara B, Uğraş S, Ertan K, Köksal Y. Evaluation of clinical features, treatment approaches and treatment outcomes of children with non-Hodgkin lymphoma. J Contemp Med. Kasım 2022;12(6):989-996. doi:10.16899/jcm.1202662