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

Yıl 2022, Cilt 12, Sayı 6, 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.

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, Cilt 12, Sayı 6, 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

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

Buket KARA>
Selcuk University School of Medicine Department of Pediatrics, Division of Pediatric Hematology and Oncology
0000-0003-4737-1901
Türkiye


Serdar UĞRAŞ>
Selcuk University School of Medicine Department of Pathology
0000-0003-0108-697X
Türkiye


Kübra ERTAN>
Selcuk University School of Medicine Department of Pediatrics
0000-0001-5393-9415
Türkiye


Yavuz KÖKSAL> (Sorumlu Yazar)
Selcuk University School of Medicine Department of Pediatrics, Division of Pediatric Hematology and Oncology
0000-0002-9190-7817
Türkiye

Destekleyen Kurum Yok
Erken Görünüm Tarihi 1 Ekim 2022
Yayımlanma Tarihi 30 Kasım 2022
Kabul Tarihi 24 Kasım 2022
Yayınlandığı Sayı Yıl 2022, Cilt 12, Sayı 6

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. 2022; 12(6): 989-996.