| Objective:(1)To understand the clinical characteristics and prognosis of Burkitt lymphoma in population.(2)To understand the survival of patients with Burkitt lymphoma and analyze the factors that affect the prognosis.(3)Compare the differences in survival prognosis between children and adolescents and explore their causes.Research methods: A retrospective analysis of clinical data of 82 Burkitt lymphoma patients admitted from Children’s Hospital of Nanjing Medical University and the First Affiliated Hospital of Nanjing Medical University from January 2010 to September 2018.Including early clinical symptoms and signs,laboratory indicators,survival prognosis.The clinical manifestations and laboratory results were summarized,and the factors affecting their prognosis were analyzed using the KM function.Results:(1)The male to female ratio of 82 Burkitt lymphoma patients was 3.32:1.The St.Jude staging system was used for children,the Annbor staging system was used for adolescents and adults.17 patients(20.73%)were stage I and II patients,and65(79.27%)were stage III and IV patients.The 53 children’s gender ratio was 3.42: 1,and the median age was 5 years.The gender ratio of 29 adolescents / adults was 3.14:1,with a median age of 30 years.(2)The symptoms of Burkitt’s lymphoma are mostly primitive abdominal involvement(63/82 76.83%),head and neck involvement(12/82 14.63%),lymph node involvement(30/82 36.59%),and thoracic and abdominal pelvic effusion(18 / 82 21.95%),followed by bone marrow involvement(15/82 18.29%),bone involvement(15/82 18.29%),central nervous system involvement(8/82 9.76%),and a small part showed soft tissue involvement(5 / 826.1%),testicular or ovarian involvement(5/82 6.1%),etc.In the patients with stage III and IV children,the three most commonly affected areas were the small intestine(26/53 49.06%),lymph nodes(19/53 35.85%),and pleural effusion(13/53 24.53%);In the III / IV adolescent / adult group,the three most commonly involved sites were lymph nodes(18/29 62.07%),bone marrow(11/29 37.93%),and bone(9/29 31.34%).Among them,the statistically significant parts are mainly concentrated in the lymph node area,the abdomen,especially the small intestine,chest,bone marrow and bone.(3)The number of Bcl-2 positive patients in the children group was greater than 95%with Ki-67,and the number of patients with LDH level of 570 U / L was significantly higher than that in the adolescent adult group.Adolescent / adult patients had significantly more ferritin levels than 150 ug / L than children.The 5-year overall survival(OS)level of patients in both groups was 67.6%.The 5-year OS in children was 80%,and the 5-year OS in adolescents / adults was 49%.The survival prognosis of children was much better than that of adolescents / adults.The KM function was used to analyze the prognosis of 82 patients by single factor analysis.The results showed that patients with LDH greater than 570 U / L and patients older than 14 years had a poor prognosis,and the difference was statistically significant(p value less than0.05).Patients with bone marrow involvement or CNS involvement have a poor prognosis in the pediatric group;patients with higher stages in the adult and adolescent groups have a worse prognosis.The results were statistically different(p value was less than 0.05).COX regression analysis showed that central nervous system and bone marrow involvement were risk factors affecting prognosis.Research conclusions:(1)The 82 male and female Burkitt lymphoma patients included in this study had a male to female ratio of 3.32: 1,and there was no significant difference between the child group and the adolescent / adult group.(2)The abdomen,bone marrow and bone are the most common sites of involvement of Burkitt’s lymphoma.Adult patients and children have significantly different involvement sites.Adult lymph node lesions are the most common.The most common sites are lymph nodes,followed by bone marrow and bone.Children with extranodal lesions are the most common site.The small intestine is the most common site,followed by lymph nodes and Pleural effusion.(3)In this study,the 5-year OS of Burkitt’s lymphoma was 67.6%,the 5-year OS of pediatric patients was 80%,and the 5-year OS of adolescent and adult patients was49%.The prognosis of children is significantly better than that of adolescents and adults.Patients with bone marrow involvement and central nervous system involvement have a poor prognosis in the pediatric group,and patients with higher stages(stages III and IV)in the adolescent / adult group have a poor prognosis. |
