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Saatci D, Zhu C, Harnden A, Hippisley-Cox J. Presentation of B-cell lymphoma in childhood and adolescence: a systematic review and meta-analysis. BMC Cancer 2024; 24:718. [PMID: 38862882 PMCID: PMC11167855 DOI: 10.1186/s12885-024-12372-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the prevalence of associated symptoms in order to improve early diagnosis. AIMS To identify clinical presentations associated with childhood and adolescent B-cell lymphomas and estimate symptom prevalence. METHODS A systematic review of observational studies and meta-analysis of proportions was carried out. Medline and EMBASE were systematically searched, with no language restrictions, from inception to 1st August 2022. Observational studies with at least 10 participants, exploring clinical presentations of any childhood and adolescent lymphoma, were selected. Proportions from each study were inputted to determine the weighted average (pooled) proportion, through random-effects meta-analysis. RESULTS Studies reported on symptoms, signs and presentation sites at diagnosis of 12,207 children and adolescents up to the age of 20. Hodgkin's lymphoma most frequently presented with adenopathy in the head-and-neck region (79% [95% CI 58%-91%]), whilst non-Hodgkin's lymphoma presented abdominally (55% [95% CI 43%-68%]). Symptoms associated with lymphoma included cervical lymphadenopathy (48% [95% CI 20%-77%]), peripheral lymphadenopathy (51% [95% CI 37%-66%]), B-symptoms (40% [95% CI 34%-44%]), fever (43% [95% CI 34%-54%]), abdominal mass (46% [95% CI 29%-64%]), weight loss (53% [95% CI 39%-66%]), head-and-neck mass (21% [95% CI 6%-47%]), organomegaly (29% [95% CI 23%-37%]), night sweats (19% [95% CI 10%-32%]), abdominal pain (28% [95% CI 15%-47%]), bone pain (17% [95% CI 10%-28%]) and abnormal neurology (11% [95% CI 3%-28%]). CONCLUSION This systematic review and meta-analysis of proportions provides insight into the heterogeneous clinical presentations of B-cell lymphoma in childhood and adolescence and provides estimates of symptom prevalence. This information is likely to increase public and clinical awareness of lymphoma presentations and aid earlier diagnosis. This review further highlights the lack of studies exploring childhood and adolescent lymphoma presentations in primary care, where patients are likely to present at the earliest stages of their disease.
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Affiliation(s)
- Defne Saatci
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK.
| | - C Zhu
- UCL Cancer Institute, University College London, London, UK
| | - A Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - J Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
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Moleti ML, Testi AM, Foà R. Childhood aggressive B-cell non-Hodgkin lymphoma in low-middle-income countries. Br J Haematol 2021; 196:849-863. [PMID: 34866182 DOI: 10.1111/bjh.17979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/04/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022]
Abstract
In high-income countries (HICs) paediatric aggressive B-cell lymphomas are curable in about 90% of cases. Much worse results, with cure rates ranging from less than 30% to about 70%, are achieved in low- and middle-income countries (LMICs), where 90% of paediatric non-Hodgkin lymphomas occur. Low socio-economic and cultural conditions, the lack of optimal diagnostic procedures, laboratory facilities and adequate supportive care exert a strong negative impact on compliance, treatment delivery, toxicity and, consequently, on the clinical outcome. Published data are scarce, generally originating from single institutions, and are difficult to compare. National and international cooperation projects have been undertaken to reduce the unacceptable gap between HICs and LMICs in the management of children with cancer, by promoting the sharing of knowledge and by implementing adequate local healthcare facilities, with initial promising results. In the present review, we will summarize the results so far obtained in the management of paediatric aggressive B-cell NHL in LMICs.
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Affiliation(s)
- Maria Luisa Moleti
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Anna Maria Testi
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, 'Sapienza' University, Rome, Italy
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3
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Ninh TP, Dinh TQ, My TTT, Thao BTP, Bang LV, Duc NM. A rare case of bilateral primary renal Burkitt lymphoma presenting with acute renal failure. Radiol Case Rep 2021; 16:2311-2314. [PMID: 34194596 PMCID: PMC8237307 DOI: 10.1016/j.radcr.2021.05.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/22/2021] [Accepted: 05/22/2021] [Indexed: 11/26/2022] Open
Abstract
Acute renal failure due to primary renal Burkitt lymphoma in children is extremely rare. We report a case with acute secondary renal failure in a 4-year-old boy who presented with abdominal pain, anorexia, and vomiting. Abdominal computed tomography scans showed bilateral nephromegaly with multiple hypoenhancing regions. Renal biopsy confirmed Burkitt lymphoma. There was no lymphadenopathy or evidence of other solid organ involvement. The patient was responsive to treatment using the EPOCH-R protocol (etoposide, prednisone, vincristine, cyclophosphamide , doxorubicin, and rituximab). Here, we describe the clinical and imaging features associated with this rare entity.
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Affiliation(s)
- Tran Phan Ninh
- Department of Radiology, National Hospital of Pediatrics, Ha Noi, Viet Nam
| | - Truong Quang Dinh
- Department of General Surgery, Ho Chi Minh City Children's Hospital, 15 Vo Tran Chi, Tan Kien, Binh Chanh, Ho Chi Minh City 700000, Vietnam
| | - Thieu-Thi Tra My
- Department of Radiology, Hanoi Medical University, Ha Noi, Viet Nam
| | - Bui-Thi Phuong Thao
- Department of Radiology, Vinmec Times City International Hospital, Ha Noi, Viet Nam
| | - Luong Viet Bang
- Department of Pathology, Tam Anh General Hospital, Ha Noi, Viet Nam
| | - Nguyen Minh Duc
- Department of Radiology, Hanoi Medical University, Ha Noi, Viet Nam.,Department of Radiology, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Ward 12 District 10, Ho Chi Minh City 700000, Viet Nam.,Department of Radiology, Children's Hospital 2, Ho Chi Minh City, Viet Nam
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4
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Rodrigues-Fernandes CI, Pérez-de-Oliveira ME, Aristizabal Arboleda LP, Fonseca FP, Lopes MA, Vargas PA, Santos-Silva AR. Clinicopathological analysis of oral Burkitt's lymphoma in pediatric patients: A systematic review. Int J Pediatr Otorhinolaryngol 2020; 134:110033. [PMID: 32302884 DOI: 10.1016/j.ijporl.2020.110033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 01/19/2023]
Abstract
The aim of this study was to integrate the available data regarding pediatric Burkitt's lymphoma (BL) of the oral cavity. A systematic review was conducted following PRISMA guidelines, through a specific search strategy. Twenty-nine publications were included in this study, resulting in a total of 144 cases. Oral BL was predominantly found in males (75.7%). The mandible was the most involved site (37.5%), and all cases clinically exhibited a swelling. Presence of EBV was observed in 33.3% of the cases, and 4 cases reported HIV-positive patients (33.3%). Chemotherapy was the leading treatment choice for oral BL (94.9%), and the overall 5-year survival was 54.3%. Regarding the quality assessment of the studies, most (19 studies; 65.5%) were classified as an overall moderate risk of bias. In conclusion, the clinicopathological characteristics of oral BL in the pediatric population comprise the sporadic and intermediate subtypes. Despite its aggressiveness, this malignancy presents a moderate overall survival.
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Affiliation(s)
- Carla Isabelly Rodrigues-Fernandes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil
| | - Maria Eduarda Pérez-de-Oliveira
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil
| | - Lady Paola Aristizabal Arboleda
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil
| | - Felipe Paiva Fonseca
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, Brazil; Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil; Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas, 13414-903, Piracicaba, São Paulo, Brazil.
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Musekwa E, Chapanduka ZC, Bassa F, Kruger M. An 8-year retrospective study of adult and paediatric Burkitt’s lymphoma at Tygerberg Hospital, South Africa. SOUTH AFRICAN JOURNAL OF ONCOLOGY 2020. [DOI: 10.4102/sajo.v4i0.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Oliveira MCL, Sampaio KC, Brito AC, Campos MK, Murao M, Gusmão R, Fernandes AAL, Viana MB. 30 Years of Experience with Non-Hodgkin Lymphoma in Children and Adolescents: a retrospective cohort study. ACTA ACUST UNITED AC 2020; 66:25-30. [PMID: 32130377 DOI: 10.1590/1806-9282.66.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Describe the clinical and demographic characteristics of pediatric patients with non-Hodgkin's lymphoma (NHL) enrolled in a tertiary unit of Pediatric Hematology between 1982-2015. PATIENTS AND METHODS A retrospective cohort study of 140 patients aged 16 years or less with NHL. Demographic characteristics, data on diagnosis, and outcomes were analyzed. The overall survival (OS) analysis and stratification by the most frequent histological subtypes were performed using the Kaplan-Meier method. RESULTS One hundred and thirty-six patients with de novo NHL and four with NHL as a second malignancy were analyzed. The median age at diagnosis was 6.4 years (interquartile range, 4.2 to 11.1 years); 101 patients were males. Four patients had primary immunodeficiency, four had human immunodeficiency virus, two post-liver transplantation, and one had autoimmune lymphoproliferative syndrome. The most frequent histological type was NHL of mature B- cell (B-NHL-B; 67.1%), with Burkitt's lymphoma being the most frequent subtype, and lymphoblastic lymphoma (LBL, 21.4%). The main clinical manifestation at the diagnosis was abdominal tumors (41.4%). During the follow-up time, 13 patients relapsed, but five of them reached a second remission. Thirty-five patients died, and 103 remained alive in clinical remission. No contact was possible for two patients. The OS at 5 years was 74.5% (± 3.8%). The OS estimated for patients with LBL, NHL-B, and the remaining was 80.4%±7.9%, 72.8%±4.7%, and 74.5%±11%, respectively (P = 0.58). CONCLUSION Our results are comparable with cohorts from other middle-income countries.
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Affiliation(s)
- Maria Christina L Oliveira
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Keyla C Sampaio
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Andrea C Brito
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Marcia K Campos
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Mitiko Murao
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
| | - Rebeca Gusmão
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Ana Angélica L Fernandes
- . Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Marcos B Viana
- . Divisão de Hematologia Pediátrica, Departamento de Pediatria, Escola de Medicina, Universidade Federal de Minas Gerais,Belo Horizonte, MG, Brasil
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7
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Malnutrition, Sepsis, and Tumor Lysis Syndrome Are Associated with Increased Rate of Acute Mortality in Mature B Cell Non-Hodgkin Lymphoma in a Pediatric Population-Study from Tertiary Care Hospital in Pakistan. Mediterr J Hematol Infect Dis 2019; 11:e2019043. [PMID: 31308919 PMCID: PMC6613629 DOI: 10.4084/mjhid.2019.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/08/2019] [Indexed: 11/08/2022] Open
Abstract
Background Outcomes of pediatric mature B cell non-Hodgkin's lymphoma in resource-challenged countries are negatively affected by an increased rate of early and toxic deaths. Aim of this study is to assess the rate of acute mortality and define significant risk factors present in children with mature B cell non-Hodgkin's lymphoma. Methods A retrospective analysis was done of patients with B cell non-Hodgkin's lymphoma from January 2012 till December 2016. Risk factors studied for acute mortality were malnutrition, stage, prior surgery with open laparotomy, lactate dehydrogenase levels, tumor lysis syndrome, sepsis, and fungal infection. Results A total of 233 patients were enrolled in the study. Eighty-five (36.4%) were below 15th percentile weight for age. Treatment was started in 226 patients. Eighty-eight percent of children showed a 20% response after COP pre-phase. Tumor lysis syndrome was developed in 20.6% (n = 48) children and 42.9% (n = 100) patients had sepsis, 71/100 patients had culture-proven sepsis. 19.7% (n = 46) patients developed fungal infection. There was 19.7% (n = 46) acute mortality. The most common cause of death was sepsis (n = 22, 47.8%) followed by acute renal failure secondary to tumor lysis syndrome. On multivariate analysis, three independent variables found significant for early death are malnutrition, sepsis, and tumor lysis syndrome. Conclusion Rate of acute mortality in mature B cell NHL is high in our set up and significant risk factors are tumor lysis syndrome, sepsis, and malnourishment at the time of presentation.
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8
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Offor UT, Akyea RK, Neequaye JE, Renner LA, Segbefia CI. The changing clinical pattern of endemic Burkitt lymphoma in Western Africa: Experience from a tertiary center in Ghana. Pediatr Blood Cancer 2018; 65:e27275. [PMID: 29873879 DOI: 10.1002/pbc.27275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND Burkitt lymphoma (BL) is the most common childhood cancer in Ghana, where the endemic variant is the predominant subtype and historically presents as a highly chemo-sensitive jaw tumor. This study aimed to update the current epidemiological characteristics of childhood BL in our institution. PROCEDURE Patient data for all children diagnosed with BL and seen at Korle Bu Teaching Hospital between January 2007 and December 2012 were retrospectively analyzed. RESULTS BL was diagnosed in 173 children (<13 years) during the study period, with the abdomen as the most common tumor site (46%) followed by the jaw (31%). Abdominal tumors were associated with advanced/disseminated disease (P = 0.002), and were more likely to occur in females irrespective of tumor stage (relative risk = 1.56 [95% CI; 1.1-12.3]). Twenty-five percent (43/173) of the study cohort died and mortality was influenced by increasing age (P = 0.02) and advanced disease (P = 0.03). Treatment delay was experienced by nine in ten patients primarily due to familial financial constraint (75%). Treatment abandonment was observed as a first event in 94% of patients and two thirds of children in the study were eventually lost to follow-up. CONCLUSION The predominance of primary abdominal tumors in our study cohort may indicate a changing epidemiological pattern of BL in Ghana. High rates of treatment delay and abandonment were evident and are likely to be contributing factors to the poor childhood cancer survival outcomes seen in resource-limited countries in Africa.
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Affiliation(s)
- Ugonna T Offor
- Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom.,Pediatric Oncology Unit, Korle Bu Teaching Hospital, Accra, Ghana
| | - Ralph K Akyea
- Pediatric Oncology Unit, Korle Bu Teaching Hospital, Accra, Ghana.,Faculty of Medicine and Health Sciences, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Janet E Neequaye
- Pediatric Oncology Unit, Korle Bu Teaching Hospital, Accra, Ghana.,Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Lorna A Renner
- Pediatric Oncology Unit, Korle Bu Teaching Hospital, Accra, Ghana.,Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Catherine I Segbefia
- Pediatric Oncology Unit, Korle Bu Teaching Hospital, Accra, Ghana.,Department of Child Health, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
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Gaytan-Morales F, Alejo-Gonzalez F, Reyes-Lopez A, Palomo M, Rodriguez-Romo L, Villareal-Martínez L, Sandoval-González A, Lopez-Facundo A, Tejocote-Romero I, Cárdenas-Cardos R, Aguilar-Ortiz M, Arreguin-Gonzalez F, Baños-Rodriguez E, Cortes-Alva D, Ellis-Irigoyen A, García-Becerra G, Rodriguez-Campos M, Gonzalez-Montalvo P, Gonzalez-Ramella O, Olaya-Vargas A. Pediatric mature B-cell NHL, early referral and supportive care problems in a developing country. Hematology 2018; 24:79-83. [DOI: 10.1080/10245332.2018.1510087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Felix Gaytan-Morales
- Servicio de Oncología, Hospital Infantil de México, Dr. Federico Gómez., Cuauhtémoc, México City, México
| | | | - Alfonso Reyes-Lopez
- Centro para Estudios Economicos y Sociales en Salud, Hospital Infantil de México, Cuauhtémoc, México City, México
| | - Miguel Palomo
- Servicio de Oncología, Hospital Infantil de México, Dr. Federico Gómez., Cuauhtémoc, México City, México
| | - Laura Rodriguez-Romo
- Canadian Cancer Trials Group, Queen’s University, Kingston, ON, Canada
- Centro Universitario Contra el Cáncer, Hospital Universitario U.A.N.L, Monterrey, NL, México
| | | | | | | | | | | | | | - Farina Arreguin-Gonzalez
- Servicio de Oncología Pediátrica, Centro Medico Nacional 20 de Noviembre ISSSTE, Mexico City, México
| | - Eduardo Baños-Rodriguez
- Servicio de Oncología Pediátrica, Centro Medico Nacional 20 de Noviembre ISSSTE, Mexico City, México
| | | | - Andrea Ellis-Irigoyen
- Servicio de Oncología Hospital Infantil Teletón de Oncología, Santiago de Querétaro, México
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Miron I, Miron L, Lupu VV, Ignat A. Silent presentation of multiple metastasis Burkitt lymphoma in a child: A case report and review of the literature. Medicine (Baltimore) 2017; 96:e7518. [PMID: 28700504 PMCID: PMC5515776 DOI: 10.1097/md.0000000000007518] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE The Burkitt lymphoma (BL) is a very aggressive B-cell non-Hodgkin's lymphoma. It accounts for 34% of lymphoma cases in children. PATIENT CONCERNS We present the case of a 6-year-old boy diagnosed with BL, who presented multiple contrasting elements of the disease: silent symptomatology, without involvement of the bone marrow at first, but with multiorgan infiltration and a fast evolution, despite starting the treatment shortly after the symptoms appeared. DIAGNOSES He was diagnosed with BL after immunophenotyping from the pleural fluid. INTERVENTIONS After a week from admission, chemotherapy was initiated according to protocol NH-BFM therapeutic group III-cytoreductive phase in the acute care ward and subsequently the AA 24 treatment. OUTCOMES Following the treatment, the patient developed medullary aplasia and cutaneous toxicity. The patient's general state remained severe during the hospitalization. LESSONS Even though the prognosis of BL has improved over time (up to 90% survival rate), in this case the evolution was unfavorable. In our patient, the symptoms appeared abruptly. They appeared late in the phase of multiple-organ dissemination, which generated the pessimistic prognosis.
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Affiliation(s)
| | - Lucian Miron
- Oncology Department, University of Medicine and Pharmacy “Gr. T. Popa”, Iasi, Romania
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Oliveira MCLA, Sampaio KC, Oliveira AC, Santos AD, Castro LP, Viana MB. Outcome of children and adolescents with lymphoblastic lymphoma. Rev Assoc Med Bras (1992) 2016; 61:417-22. [PMID: 26603004 DOI: 10.1590/1806-9282.61.05.417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/04/2015] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION lymphoblastic lymphoma (LBL) is the second most common subtype of non-Hodgkin lymphoma in children. The aim of this study was to characterize the clinical course of children and adolescents with LBL treated at a tertiary center. METHODS this is a retrospective cohort study of 27 patients aged 16 years or younger with LBL admitted between January 1981 and December 2013. Patients were treated according to the therapy protocol used for acute lymphoblastic leucemia. Diagnosis was based on biopsy of tumor and/or cytological examination of pleural effusions. The overall survival was analyzed using the Kaplan-Meier method. RESULTS the median age at diagnosis was 11.6 years (interquartile range, 4.6- 13.8). LBL had T-cell origin in 16 patients (59%). The most common primary manifestation in T-cell LBL was mediastinal involvement, in 9 patients (56%). Intra-abdominal tumor was the major site of involvement in patients with precursor B-LBL. Most patients had advanced disease (18 patients - 67%) at diagnosis. Twenty-four patients (89%) achieved complete clinical remission. After a median follow-up of 43 months (interquartile range, 6.4-95), 22 patients (81%) were alive in first complete remission. Five children (18.5%) died, three of them soon after admission and two after relapsing. The probability of survival at five years for 20 patients with de novo LBL was 78% (SD 9.4). CONCLUSION our findings confirm the favorable prognosis of children with LBL with an intensive chemotherapy regimen derived from ALL therapy.
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Affiliation(s)
| | - Keyla Christy Sampaio
- Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Aieska Dantas Santos
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lúcia Porto Castro
- Pathology Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marcos Borato Viana
- Pediatrics Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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12
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Oliveira MCLA, Sampaio KC, Oliveira AC, Santos AD, Castro LP, Viana MB. Outcome of children and adolescents with lymphoblastic lymphoma. Rev Assoc Med Bras (1992) 2016; 62:59-64. [DOI: 10.1590/1806-9282.62.01.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 05/04/2015] [Indexed: 01/19/2023] Open
Abstract
SUMMARY Introduction: lymphoblastic lymphoma (LBL) is the second most common subtype of non-Hodgkin lymphoma in children. The aim of this study was to characterize the clinical course of children and adolescents with LBL treated at a tertiary center. Methods: this is a retrospective cohort study of 27 patients aged 16 years or less with LBL admitted between January 1981 and December 2013. Patients received intensive chemotherapy regimen derived from acute lymphoblastic leukemia (ALL) therapy. Diagnosis was based on biopsy of tumor and/or cytological examination of pleural effusions. The overall survival was analyzed using the Kaplan-Meier method. Results: the median age at diagnosis was 11.6 years (interquartile range, 4.6-13.8). LBL had T cell origin in 16 patients (59%). The most common primary manifestation in T-cell LBL was mediastinum involvement in 9 patients (56%). Intra-abdominal tumor was the major site of involvement in patients with pB-LBL. Most patients had advanced disease (18 patients - 67%) at diagnosis. Twenty-four patients (89%) achieved complete clinical remission. After a median follow-up of 43 months (interquartile range, 6.4-95), 22 patients (81%) were alive in first complete remission. Five children (18.5%) died, three of them soon after admission and two after relapsing. The probability of survival at five years for 20 patients with de novo LBL was 78% (SD 9.4). Conclusion: our findings confirm the favorable prognosis of children with LBL with an intensive chemotherapy regimen derived from ALL therapy.
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