The Prognostic and Risk Factors for Children With High-Risk Mature B-Cell Non-Hodgkin's Lymphoma: A Retrospective Multicenter Study

IF 2.9 2区医学 Q2 ONCOLOGY

Cancer Medicine Pub Date : 2024-11-08 DOI:10.1002/cam4.70309

Xiaoming Wang, Luping Ding, Yongjun Fang, Jie Yan, Ju Gao, Liangchun Yang, Aiguo Liu, Jun Lu, Jingfu Wang, Aijun Zhang, Yijin Gao, Xiuli Ju

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Abstract

Backgrounds and Aims

Our previous study (CCCG-BNHL-2015) reported the treatment strategies and outcomes of pediatric B-cell non-Hodgkin's lymphoma (B-NHL) in China which showed that children in low-risk groups already have a dramatically favorable prognosis. However, for high-risk groups, the prognosis still needs to be improved. In this study, we aimed to identify the factors influencing prognosis in high-risk groups (stage III and stage IV).

Results

Our results revealed that gender, lactate dehydrogenase (LDH) level, stage at the time of diagnosis, and early complete remission (CR) achievement were significant factors influencing prognosis (p < 0.05). The 3-year EFS rate for R4 group patients without rituximab treatment was only 25.0% ± 20.4%. Among all patients in stage IV, the 5-year EFS rates for those with involvement of only bone marrow (BM) or central nervous system (CNS) were 83.0% ± 4.5%, 81.8% ± 8.2%, but the 5-year EFS rates for those with both BM and CNS involved were only 37.5% ± 15.3% (p = 0.002). For stage III patients with LDH ≥ 4N, the 5-year EFS rates for those achieving CR and those not achieving CR after 2 treatment cycle were 88.9% ± 5.2% and 67.9% ± 7.3%(p = 0.036).

Conclusions

Therefore, R4 group patients benefited from rituximab treatment. However, children at stage III, LDH ≥ 4N not achieving CR after the 2nd treatment cycle, and those with both BM and CNS involved are still at a very high risk of treatment failure. This study serves as a crucial reference for optimizing risk stratification, refining treatment categorizations, and optimizing treatment protocols.

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高危成熟 B 细胞非霍奇金淋巴瘤患儿的预后和风险因素：一项回顾性多中心研究。

背景和目的：我们之前的研究（CCCG-BNHL-2015）报道了中国小儿B细胞非霍奇金淋巴瘤（B-NHL）的治疗策略和结果，结果显示低危人群的预后已经非常好。然而，高危人群的预后仍有待改善。本研究旨在确定影响高危人群（Ⅲ期和Ⅳ期）预后的因素：结果表明，性别、乳酸脱氢酶（LDH）水平、诊断时的分期和早期完全缓解（CR）是影响预后的重要因素（p 结论：R4 组患者的预后较好：因此，R4 组患者从利妥昔单抗治疗中获益。然而，处于Ⅲ期、LDH≥4N且在第2个治疗周期后未达到CR的患儿，以及同时累及骨髓和中枢神经系统的患儿，治疗失败的风险仍然很高。这项研究为优化风险分层、完善治疗分类和优化治疗方案提供了重要参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.