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Meena JP, Gupta AK, Parihar M, Seth R. Clinical profile and outcomes of Non-Hodgkin's lymphoma in children: A report from a tertiary care hospital from India. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_70_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Non-Hodgkin's lymphoma (NHL) is an aggressive malignancy. Its outcome has improved over the past decades. Although it accounts for 8%–10% of all childhood cancers, very less information about its clinical presentation and outcomes is available from India. Our objective was to study the clinical presentation and outcomes in children (<15 years) with NHL at our center. Methodology: We retrospectively analyzed 26 children diagnosed with NHL at our center from August 2008 to June 2014 and followed them up to May 2017. Results: The median age at the time of diagnosis was 7.7 years (2.5–13 years). Abdominal distension and an abdominal lump were the most common presenting features occurring in 75%, followed by fever (73.8%) and weight loss (46.2%). Most patients had advanced-stage (Stage III/IV, 92.3%) disease at presentation. The primary presentation was extranodal in 57.7%, nodal in 26.9%, and combined in 15.4%. Burkitt's lymphoma (BL) was the most common subtype (46.2%), followed by T-lymphoblastic lymphoma, diffuse large B-cell lymphoma, and anaplastic large-cell lymphoma. Three patients did not take treatment. The median follow-up of patients was 48 months (36–99 months). Nineteen patients achieved remission and four had progressive disease. Significantly better event-free survival (EFS) was found with younger age and lower stage of presentation. The EFS did not significantly differ with sex, group of disease, lactate dehydrogenase levels, and presenting features. Conclusions: Our cohort of patients with NHL showed characteristics similar to those reported from other developing countries. NHL occurred at a younger age, with a higher incidence of BL. The outcome for patients aged >10 years was poor. The outcome of NHL was comparable to that of other centers in the world.
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Affiliation(s)
- Jagdish Prasad Meena
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kumar Gupta
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Mansingh Parihar
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, Division of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India
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Sherief LM, Elsafy UR, Abdelkhalek ER, Kamal NM, Youssef DM, Elbehedy R. Disease patterns of pediatric non-Hodgkin lymphoma: A study from a developing area in Egypt. Mol Clin Oncol 2014; 3:139-144. [PMID: 25469284 DOI: 10.3892/mco.2014.425] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 09/05/2014] [Indexed: 11/05/2022] Open
Abstract
Non-Hodgkin lymphoma (NHL) accounts for 8-10% of all childhood cancers. NHL collectively represents various lymphoid malignancies with diverse clinicopathological and biological characteristics. In this study, we aimed to describe the epidemiological and clinicopathological characteristics and treatment outcomes of pediatric NHL patients treated at the Pediatric Oncology Unit of Zagazig University Hospital and the Benha Specialized Pediatric Hospital. We conducted a cross-sectional retrospective study by reviewing the medical records of 142 patients admitted with a diagnosis of NHL over a period of 8 years (February, 2004 to February, 2012) in these two Oncology Units. The age at presentation ranged between 2 and 15 years, with a mean ± standard deviation (SD) of 6.1±2.8 years and a male:female ratio of 1.7:1. Abdominal involvement was the most common presentation (73.2%). Burkitt's lymphoma (BL) was the most common NHL subtype (69%), followed by lymphoblastic lymphoma, diffuse large B-cell lymphoma and anaplastic large-cell lymphoma, accounting for 18.3, 10.6 and 2.1% of the cases, respectively. The majority of the patients (88.7%) had been diagnosed with advanced disease (Murphy stage III/IV). Complete remission was achieved in 120 cases (84.5%). A total of 16 patients (11.3%) succumbed to the disease during the first few months and 6 patients (4.2%) remained alive following relapse. The mean follow-up duration ± SD was 34.6±25.1 months (range, 3-84 months). The 5-year overall survival (OS) and event-free survival (EFS) rates were 88.7 and 85.1%, respectively. None of the clinical, epidemiological or pathological variables exhibited a statistically significant association with the OS or EFS. In conclusion, NHL occurs at a younger age, with a higher incidence of BL and advanced-stage disease. The outcome of NHL in our two centers was satisfactory, approaching the international rates.
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Affiliation(s)
- Laila M Sherief
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt ; Benha Specialized Pediatric Hospital, Benha, Qalyubia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Usama R Elsafy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Elhamy R Abdelkhalek
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt ; Benha Specialized Pediatric Hospital, Benha, Qalyubia, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Naglaa M Kamal
- Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Doaa M Youssef
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rabab Elbehedy
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Al Sharqiyah, Faculty of Medicine, Cairo University, Cairo, Egypt
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Paediatric lymphoma in China: a clinicopathological study of 213 cases. Pathology 2012; 44:622-5. [PMID: 23149377 DOI: 10.1097/pat.0b013e328359cfba] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM This retrospective study was conducted to evaluate information on paediatric lymphoma in China. METHODS We reviewed the pathological files of patients less than 12 years of age with lymphoma in Shanghai Xinhua Hospital from January 1982 to June 2009. SPSS version 11.0 was used to analyse the results. RESULTS Of the 213 subjects, 176 (82.6%) had non-Hodgkin's lymphoma (NHL) and 37 (17.4%) had Hodgkin's lymphoma (HL). All NHL cases had diffuse and high grade tumours, and 33.5% of these tumours primarily involved extra-nodal sites. Of the NHL cases, 56.6%, 43.3%, and 1.7% were derived from T, B, and null cells, respectively. Lymphoblastic lymphoma (LL, 50.6%), Burkitt's lymphoma (BL, 28.4%), and anaplastic large cell lymphoma (ALCL, 12.5%) comprised the majority of the NHL cases. A significant difference was found in the frequency of stage I/II cases between LL and ALCL. Paediatric HL resembled the disease in adults. CONCLUSIONS Paediatric lymphoma in China is different from that in Western countries with respect to the incidence rate of HL and BL. The distribution pattern of NHL histological subtypes is more similar to that in Japan than that in Pakistan. These features suggest ethnic or geographic variations.
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Hirayama M, Azuma E, Nakagawa-Nakazawa A, Kumamoto T, Iwamoto S, Amano K, Tamaki S, Usui E, Komada Y. Interleukin-10 spot-forming cells as a novel biomarker of chronic graft-versus-host disease. Haematologica 2012; 98:41-9. [PMID: 22733028 DOI: 10.3324/haematol.2012.069815] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Although there are National Institutes of Health consensus criteria for the global assessment of chronic graft-versus-host disease, no validated biomarkers have been established for this disease. Furthermore, whereas the role of T cells, B cells, and dendritic cells in chronic graft-versus-host disease has been established, the contribution of monocytes has not been clearly addressed. Using an enzyme-linked immunospot assay, we measured the spot-forming cells for interferon-γ, interleukin-4, interleukin-10, and interleukin-17 in unstimulated peripheral blood of patients following allogeneic hematopoietic stem cell transplantation. Other immunological examinations, including skin biopsy, were also done. Fifty-seven patients were enrolled. Interleukin-10 spot-forming cells were evaluable for therapeutic monitoring in 16 patients with chronic graft-versus-host disease. The number of interleukin-10 spot-forming cells in patients with active chronic graft-versus-host disease was significantly higher than the number in those with no or inactive chronic graft-versus-host disease. Interleukin-10 was predominantly produced by monocytes. CD29 expression on monocytes in patients with active chronic graft-versus-host disease was elevated. The level of plasma fibronectin, a ligand of CD29, correlated with the number of interleukin-10 spot-forming cells. Immunohistochemical analysis of the skin in active chronic graft-versus-host disease showed that infiltrating CD29(+) monocytes might produce interleukin-10. A novel biomarker, interleukin-10 spot-forming cells, shows promise as both a diagnostic and prognostic indicator for chronic graft-versus-host disease, and may allow for early intervention prior to the onset of the disease. Measurement of interleukin-10 spot-forming cells would be helpful in clinical trials and in patients' management.
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Affiliation(s)
- Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Edobashi, Tsu, Mie, Japan
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Fujita N, Kobayashi R, Takimoto T, Nakagawa A, Ueda K, Horibe K. Results of the Japan Association of Childhood Leukemia Study (JACLS) NHL-98 protocol for the treatment of B-cell non-Hodgkin lymphoma and mature B-cell acute lymphoblastic leukemia in childhood. Leuk Lymphoma 2011; 52:223-9. [PMID: 21261497 DOI: 10.3109/10428194.2010.537794] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Naoto Fujita
- Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Naka-ku, Hiroshima, Japan.
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Freitas RDA, Veras Barros SSL, Quinderé LB. Oral Burkitt's lymphoma--case report. Braz J Otorhinolaryngol 2008; 74:458-61. [PMID: 18661023 PMCID: PMC9442611 DOI: 10.1016/s1808-8694(15)30583-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2005] [Accepted: 09/13/2005] [Indexed: 11/29/2022] Open
Abstract
Burkitt's lymphoma is a poorly differentiated rare and aggressive type of non-Hodgkin's lymphoma. This article reports the case of a male child aged seven years, who was examined at the Odontopediatric Clinic of the UFRN Dentistry Department. The patient presented a tumor in the premolar region of the mandible; teeth were mobile in this region. Radiology revealed a diffuse radioluscent area which was diagnosed histopathologically as Burkitt's lymphoma. The patient was treated with polychemotherapy; complete remission of the disease was attained.
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Fujita N, Mori T, Mitsui T, Inada H, Horibe K, Tsurusawa M. The role of hematopoietic stem cell transplantation with relapsed or primary refractory childhood B-cell non-Hodgkin lymphoma and mature B-cell leukemia: a retrospective analysis of enrolled cases in Japan. Pediatr Blood Cancer 2008; 51:188-92. [PMID: 18428432 DOI: 10.1002/pbc.21585] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND There have been excellent treatment results for children with B-cell non-Hodgkin lymphoma (B-NHL) and mature B-cell leukemia (B-ALL) in the last few decades. However, a small subset of relapsed or refractory patients, after first-line therapy, still have a poor prognosis. PROCEDURE Thirty-three patients with relapsed or primary refractory B-NHL/B-ALL among 327 newly diagnosed patients between 1996 and 2004 were analyzed retrospectively. RESULTS After salvage therapy, 18 patients were chemotherapy-sensitive and 15 patients suffered from progression. Among 18 patients who had a chemotherapy-sensitive disease, 4 of 5 patients who underwent hematopoietic stem cell transplantation (HSCT) during remission survived without progression, while 3 of 12 patients who did not receive HSCT were alive without disease progression. Fifteen patients never sensitive to salvage therapy died. CONCLUSIONS Patients with relapsed/primary refractory B-NHL/B-ALL have a poor prognosis with current treatment approaches, while the patients sensitive to salvage therapy have a respectable chance to achieve a sustained complete second remission with HSCT.
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Affiliation(s)
- Naoto Fujita
- Department of Pediatrics, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima 730-8619, Japan.
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Abstract
O linfoma de Burkitt é um raro e agressivo tipo de linfoma não-Hodgkin pobremente diferenciado. O presente relato trata de uma criança do sexo masculino, com sete anos de idade, que foi examinada na Clínica de Odontopediatria do Departamento de Odontologia da UFRN, exibindo uma massa tumoral na região de pré-molares mandibulares com mobilidade dentária. O exame radiográfico revelou uma área radiolúcida difusa e o diagnóstico histopatológico foi de linfoma de Burkitt. O paciente foi tratado por poliquimioterapia e obteve completa remissão da patologia.
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Hwang IG, Yoo KH, Lee SH, Park YH, Lim TK, Lee SC, Park S, Park BB, Ko YH, Kim K, Koo HH, Kim WS. Clinicopathologic Features and Treatment Outcomes in Malignant Lymphoma of Pediatric and Young Adult Patients in Korea: Comparison of Korean All-Ages Group and Western Younger Age Group. ACTA ACUST UNITED AC 2007; 7:580-6. [DOI: 10.3816/clm.2007.n.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Non Hodgkin lymphoma represent about 5% of childhood cancer. They are the third most common group of cancers in children and adolescents, after cerebral tumours and leukemias. They differ from adult lymphomas as they are all high grade tumours, always diffuse and often associated with extra-nodal diseases. Three main histological subtypes predominate: Burkitt, lymphoblastic and anaplastic large cell lymphomas. As the clinical progression is growing fast and treatment different between the 3 subtypes, the diagnosis must be rapidly done and with accuracy.
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Affiliation(s)
- Nicole Brousse
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Necker-Enfants Malades, AP-HP, UPRES EA 219, Université Paris V, 149, rue de Sèvres, 75015 Paris, France.
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