| Objective: To analyse the clinical hematological features,treatment outcome and prognostic factors in patients of Burkitt lymphoma/leukemia in our hospital.Methods: 34 patients diagnosed as Burkitt lymphoma/leukemia in our hospital were admitted.The collected clinical data of patients included gender,age,symptoms,primary onset site,extranodal involvement,blood analysis before treatment,biochemistry analysis,ultrasound,CT,PET-CT,cerebrospinal fluid analysis,bone marrow aspiration or/and biopsy,tissue pathology,immunohistochemistry,genetic testing,chromosome analysis,regimen,treatment outcome evaluation and long term survival.Using SPSS software to analyze the therapeudic effect and related factors which may do affect the prognosis of Burkitt lymphoma/leukemia.Results: 1.Out of the 34 Burkitt lymphoma/leukemia patients,the median age was14 years old(range from 2 years to 78 years),the ratio of male/female was 5.8:1,27cases(79.4%)was in advanced stages(stage Ⅲ or Ⅳ),24 cases(70.6%)had IPI scores in 2-5 points.The most common primary onset site was either head or neck,followed by the abdomen.There were 58.8%(20/34)of the patients involved bone marrow,32.3%(11/34)of the patients were diagnosed as ALL-L3 and 11.7%(4/34)of the patients involved the central nervous system.2.In children,64.7%(11/17)of the cases were in advanced stages,in which head or neck were the most commonly involved parts,followed by bone marrow.In adults,94.1%(16/17)of the cases were in advanced stages,most commonly involving the bone marrow,followed by abdomen.3.EBV infection was detected in 8/23(34.7%)patients.13/18(72.2%)patients was positive of IGH/MYC fusion or C-MYC FISH tests.4.In 28 patients treated in our hospital,14 children were all treated by Chinese children B-NHL2010 regimen with complete remission rate of 78.5%.14 adults were mainly treated by R-Hyper-CVAD/MA regimen with complete remission rate of 78.5%.Out of the 28 patients,89.2% of the patients had grade Ⅲ/Ⅳ bone marrow depression during chemotherapy,and the infection rate was 75%,7.1% of the patients had tumor lysis syndrome.5.1 year and 2 year OS of children were both 92.7%.1 year and 2 year PFS of children were both 92.9%.1 year and 2 year OS of adults were 49.7% and39.8%,1 year and 2 year PFS of adults were 51.6% and 38.7%.6.Univariate survival analysis showed that more than 14 years old,,born marrow involvement,anemia,decrease of platelet and albumin effected the prognosis of survival.Cox regression analysis showed that anemia was the independent prognostic factors of Burkitt lymphoma/leukemia.Conclusion: 1.Burkitt lymphoma/leukemia is a kind of B-cell non-Hodgkin’s lymphoma which more easily to involve males than females,often presents in extranodal sites,bone marrow and CNS involvements are common.Most of patients were in advanced stages when diagnosed.Head or neck was the most commonly involved site in children,whereas bone marrow was the most commonly involved site in adults.2.C-MYC translocation is the genetic characteristic of Burkitt lymphoma/leukemia.34.7% of the patients had EBV infection in Burkitt lymphoma/leukemia.3.More than 14 years old,born marrow involvement,anemia,decrease of platelet and albumin were the prognostic factors of Burkitt lymphoma/leukemia.Only anemia was the independent prognostic factor.4.The outcomes of adults were worse than children,the reasons need to be explored deeply,maybe related to the treatments. |
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