The Clinical Features And Prognosis Of Children Mature B-cell Non-Hodgkin Lymphoma(B-NHL):30 Cases Reported

Objective:This study aimed to evaluate the clinical characteristics and chemotherapy efficacy in 30 children with mature B-cell non-Hodgkin's lymphoma through the retrospective analysis,explore the differences between different pathological types,meanwhile analyse the long-term survival rate and prognostic factors,and provide a basis for improving the prognosis.Methods:Thirty children with mature B-NHL,newly diagnosed and treated in the Pediatric Hematology Department of Fujian Medical University Union Hospital from January 2011 to December 2016,were enrolled.Chemotherapy scheme was adopted to CCCG-B-NHL-2010 as the main framework,adding Rituximab properly,evaluated the efficacy and the long-term survival rate.Univariate Analysis was adopted to study the prognostic factors.These factors were according to gender,age,pathological type,clinical stage,bone marrow invasion,central nervous system invasion and LDH.The SPSS 23 statistical software was used.tested was used to the count data.The 3-years event-free survival rate(EFS)were calculated and analyzed by Kaplan-Meier method,and the difference of the survival rate between groups were compared.Results:In the 30 cases,25 male(83.3%)and 5 female(16.7%),male to female ratio was 5:1,age of onset was 1.1-12,median age was 6.There were 19 cases of burkitt lymphoma(63.3%),8 cases diffuse large B-cell lymphoma(26.7%)and 3 cases unclassifiable B-cell lymphoma(10%).The initial symptom was observed: 15 cases ofcervical mass(50%),11 cases of maxillofacial mass(36.7%),9 cases of liver and spleen swelling(30%),6 cases of abdominal mass(20%),5 cases of exophthalmos(16.7%).15 cases of LDH < 500 U/L,3 cases of 500-1000 IU/L,12 cases of LDH?1000 IU/L.0,3,9,6,and 12 patients were in stages I,II,III,IV and leukemia,respectively.This group of 30 patients cases treated with CCCG-B-NHL2010,among 22 cases were combined with rituximab during the treatment:24patients attained complete remission,2 patients induction failure,and 4 patients relapsed.Chemotherapy complications were tumor lysis syndrome of 3 cases,acute pancreatitis of 2 cases,and gastrointestinal bleeding of 3 cases.Median follow-up time were 19.5(6.75-43.5)months.The estimated 3 year overall event-free survival rates was 82.5%±1.39%.The 3-year EFS was 80.4%±1.74% vs.75.0%±3.00% for patients with chemotherapy combined with rituximab and chemotherapy only;100% and 72.3%±2.08% with DLBCL and BL;100%,100%,83.3%±2.98% and 61.1%±3.08% with stage II,III,IV and B-ALL,respectively.Bone marrow infiltration was significantly associated with prognosis,while other factors such as pathological type,stage,LDH,gender,age,CNS infiltration,lymph node enlargement,facial mass and abdominal mass,was independent of prognosis.Conclusion:The estimated 3 year overall event-free survival rates was exceeded 80% in this study.There was no significant difference in 3-year EFS between patients treated with chemotherapy combined with rituximab and those with chemotherapy only.Bone marrow infiltration is an important factor affecting the prognosis in children mature B-NHL patients.The efficacy of B-AL need to be further improved.