The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study
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 grou...
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Wiley
2024-11-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70309 |
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| author | Xiaoming Wang Luping Ding Yongjun Fang Jie Yan Ju Gao Liangchun Yang Aiguo Liu Jun Lu Jingfu Wang Aijun Zhang Yijin Gao Xiuli Ju |
| author_facet | Xiaoming Wang Luping Ding Yongjun Fang Jie Yan Ju Gao Liangchun Yang Aiguo Liu Jun Lu Jingfu Wang Aijun Zhang Yijin Gao Xiuli Ju |
| author_sort | Xiaoming Wang |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-cdc0f92d55c345a999e61811c9c3a54c |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-cdc0f92d55c345a999e61811c9c3a54c2024-11-13T07:40:35ZengWileyCancer Medicine2045-76342024-11-011321n/an/a10.1002/cam4.70309The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter StudyXiaoming Wang0Luping Ding1Yongjun Fang2Jie Yan3Ju Gao4Liangchun Yang5Aiguo Liu6Jun Lu7Jingfu Wang8Aijun Zhang9Yijin Gao10Xiuli Ju11Department of Pediatrics Qilu Hospital of Shandong University Jinan Shandong Province ChinaDepartment of Pediatrics Qilu Hospital of Shandong University Jinan Shandong Province ChinaDepartment of Hematology/Oncology Children's Hospital of Nanjing Medical University Nanjing Jiangsu Province ChinaDepartment of Pediatric Oncology Tianjin Medical University Cancer Institute and Hospital Tianjin ChinaDepartment of Pediatrics West China University Second Hospital of Sichuan University Chengdu Sichuan Province ChinaDepartment of Pediatric Hematology/Oncology Xiangya Hospital of Central South University Changsha Hunan Province ChinaDepartment of Pediatric Hematology/Oncology Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Hematology/Oncology Children's Hospital of Soochow University Soochow Jiangsu Province ChinaDepartment of Pediatric Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong Province ChinaDepartment of Pediatrics Qilu Hospital of Shandong University Jinan Shandong Province ChinaDepartment of Hematology/Oncology School of Medicine, Shanghai Children's Medical Center, Shanghai Jiaotong University Shanghai ChinaDepartment of Pediatrics Qilu Hospital of Shandong University Jinan Shandong Province ChinaABSTRACT 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.https://doi.org/10.1002/cam4.70309childrenhigh‐risk mature B‐NHLrisk factorsrituximab |
| spellingShingle | Xiaoming Wang Luping Ding Yongjun Fang Jie Yan Ju Gao Liangchun Yang Aiguo Liu Jun Lu Jingfu Wang Aijun Zhang Yijin Gao Xiuli Ju The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study Cancer Medicine children high‐risk mature B‐NHL risk factors rituximab |
| title | The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study |
| title_full | The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study |
| title_fullStr | The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study |
| title_full_unstemmed | The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study |
| title_short | The Prognostic and Risk Factors for Children With High‐Risk Mature B‐Cell Non‐Hodgkin's Lymphoma: A Retrospective Multicenter Study |
| title_sort | prognostic and risk factors for children with high risk mature b cell non hodgkin s lymphoma a retrospective multicenter study |
| topic | children high‐risk mature B‐NHL risk factors rituximab |
| url | https://doi.org/10.1002/cam4.70309 |
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