Clinical Features And Prognosis Ananlysis Of Non-Hodgkin’s Lymphoma In Children

Objective:To explore the clinical features and therapeutic effects of non-hodgkin’s lymphoma in children,and to analyze the prognosis,so as to further guide the diagnosis and treatment of non-hodgkin’s lymphoma in children.Methods:Retrospective analysis of the clinical data of 41 children with NHL who were hospitalization in the pediatric blood ward in the second hospital of He Bei Medical University from January 1,2014 to December 31,2019.1.Inclusion criteria:(1)All children were ≤14 years old.(2)All children conformed to the 2011 NHL diagnosis process,and were diagnosed by focal biopsy or bone marrow cytology.(3)The clinical data of many inpatients were only counted at the time of first hospitalization.(4)The collected cases were pathologically classified according to the WHO classification and classification standard in 2008,and the staging was conducted according to the st.Jude NHL staging system.2.A case extract table was designed,and 7 indexes including gender,age,pathological type,clinical stage,with or without giant tumor mass,with or without bone marrow infiltration,and with or without organ infiltration were systematically recorded in the included group.3.A follow-up table was designed to calculate the survival of the included children and the survival time.Statistics and analysis of data: gender,age,the clinical stage,a huge tumor mass,bone marrow infiltration,organ infiltration.Gender,age,huge tumor mass,organ infiltration,bone marrow infiltration for survival were analyzed.4.Statistical methods: The statistical software used SPSS20.0.Count data was represented by the percentage.The measurement data were represented by average number ± standard deviation.Kaplan-Meier method was used to calculate one-year and three-years overall survival rates and event-free survival rates and to draw survival curves.And using Log-Rank test to compare survival curves.COX regression model was used to screen the influence of each factor on the survival time.COX multi-risk regression model was further established to screen the independent influencing factors through multi-factor analysis.Chi-square test was used for distribution of indicators in the prognosis and analysis of the correlation analysis within the group,and P<0.05 indicates that the difference was statistically significant.Results:1.Gender and age: 29 cases were males and 12 cases were females,with a male to female ratio of 2.42:1.Ages ranged from November months old to 14 years old,with a average age of 8.73±3.32 years old;2.Clinical features:The main reasons for seeking medical treatment include 13 cases of the discovery lumps,10 cases of lymph nodes enlargement,9 cases of the digestive system symptoms,5 cases of blood system,2 cases of respiratory symptoms,1 case of abnormal head facial features and 1 case of musculoskeletal symptoms,which the discovery lumps,lymph nodes enlargement and the digestive system symptoms were the main clinical manifestations.In those children,10 cases of huge tumor mass,8 cases of bone marrow infiltration,20 cases of liver,spleen,pancreas,kidney,ovary,testis and other organs infiltration,among which organ infiltration was the most common;3.Pathological types and stages:There were 16 cases of lymphoblastic lymphoma,16 cases of mature B cell lymphoma,9 cases of anaplastic large cell lymphoma.The clinical stages of the children in this group were 6 cases of stage Ⅱ,19 cases of stage Ⅲ,and 16 cases of stage Ⅳ;4.Survival situation analysis:Kaplan-Meier analysis showed that the 1-year overall survival rate and event-free survival rate of 41 children were 80.5%±6.2%,and the 3-years overall survival rate of 32 children was 68.8%±8.2%.The 3-years event-free survival rate was 56.2%±8.8%.The Log-Rank test was used to analyze the survival curves of children.There was a difference in the survival curves of children with or without giant tumor mass,and was statistically significant;5.Analysis of factors affecting prognosis:The chi-square test was used for the correlation analysis within the group,and the Log-Rank test was used to compare the survival curves of children,and COX regression model single-factor screening showed that only the giant tumor mass had influence on the survival time of children with non-hodgkin’s lymphoma.Multivariate analysis of COX regression model showed that the giant tumor mass and bone marrow infiltration were independent prognostic factors.Therefore,giant tumor mass had an impact on the prognosis of children with NHL.Conclusion:1.The clinical manifestations of NHL in children were diverse,and the tumor was the most common reason for seeking medical treatment,and the diagnosis of children was usually in the late stage.2.NHL in children had different pathological types,among which T lymphoblastic lymphoma,burkitt’s lymphoma and anaplastic large cell lymphoma were the most common.3.NHL in children was more common in males,but the prognosis of NHL in children was unrelated to gender.4.The 1-year overall survival rate of NHL in children was 80.5%±6.2%,consistent with the domestic data,and the 3-years overall survival rate was68.8%±8.2%,slightly lower than the domestic data.Children’s NHL was currently considered a curale tumor.5.In this study,the prognosis of children with NHL was related to giant tumor mass,but there was no significant correlation with gender,age,bone marrow infiltration,organ infiltration,etc.