Korean J Hematol.  2006 Sep;41(3):157-166. 10.5045/kjh.2006.41.3.157.

Treatment Outcome and Prognostic Factors for Children with Advanced Non-Hodgkin's Lymphoma at a Single Institution

Affiliations
  • 1Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jjseo@amc.seoul.kr

Abstract

BACKGROUND: Non-Hodgkin's lymphoma (NHL) accounts for over 80% of pediatric malignant lymphoma in Korea; the event free survival (EFS) of advanced stage NHL has been reported to be 60 to 70%. We accessed the outcome of advanced stage pediatric NHL at a single institution.
METHODS
Pediatric patients who were diagnosed as stage 3 or 4 with NHL from May 1991 to June 2004 at Asan Medical Center were analyzed for outcomes according to histopathology, gender, age at present, involvement of bone marrow or central nervous system (CNS), and serum level of lactate dehydrogenase (LDH).
RESULTS
Sixty-three patients were enrolled in this study. The head and neck were the most common primary site. The five-year EFS and overall survival (OS) were 68% and 78%, respectively. Five-year EFS for lymphoblastic, Burkitt, anaplastic large cell and diffuse large B cell lymphoma were 62%, 86%, 74% and 63%, respectively. Five-year EFS and OS for patients with LDH< or =500IU/L were 85% and 100%, while those with LDH > 500IU/L were 64% and 72% (P=0.04). There was no significant difference in EFS or OS with regard to other factors. Sixteen out of the 63 patients relapsed, and the five-year OS for those who relapsed was 44%.
CONCLUSION
The outcome of patients with advanced stage NHL treated at our institution was comparable with previous reports. High serum level of LDH at diagnosis proved to be a poor prognostic factor. New effective treatment regimens are needed to improve the outcome of pediatric patients with relapsed NHL.

Keyword

Non-Hodgkin's lymphoma; Advanced stage; Outcome; Prognostic factor; Children

MeSH Terms

Bone Marrow
Central Nervous System
Child*
Chungcheongnam-do
Diagnosis
Disease-Free Survival
Head
Humans
Korea
L-Lactate Dehydrogenase
Lymphoma
Lymphoma, B-Cell
Lymphoma, Non-Hodgkin*
Neck
Treatment Outcome*
L-Lactate Dehydrogenase

Figure

  • Fig. 1 Five-year event free survival (EFS) and overall survival (OS) of total pediatric patients with advanced stage non-Hodgkin's lymphoma. The estimates are means±SE.

  • Fig. 2 Five-year event free survival (EFS) and overall survival (OS) of pediatric patients with non-Hodgkin's lymphoma according to serum lactate dehydrogenase (LDH) level. A: EFS at 5 years for pediatric patients with serum LDH≤500 IU/L, B: EFS at 5 years for pediatric patients with serum LDH>500 IU/L: P=0.15, C: OS at 5 years for pediatric patients with serum LDH≤500 IU/L, D: OS at 5 years for pediatric patients with serum LDH>500 IU/L: P=0.04. The estimates are means±SE.

  • Fig. 3 Five-year overall survival (mean±SE) of pediatric patients with relapsed non-Hodgkin's lymphoma.


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