Treatment Outcome of Childhood B-cell Lymphoma and L3 Acute Lymphoblastic Leukemia from a Single Institution.
- Author:
Yeon Jung LIM
1
;
Yoon Jung KIM
;
Joon Sup SONG
;
Mi Jung LEE
;
Jong Jin SEO
;
Hyung Nam MOON
;
Thad T GHIM
Author Information
1. Division of Hematology, Oncology and BMT, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. jjseo@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Burkitt's lymphoma;
L3 acute lymphoblastic leukemia;
Chemotherapy;
Children
- MeSH:
B-Lymphocytes*;
Burkitt Lymphoma;
Central Nervous System Diseases;
Child;
Chungcheongnam-do;
Diagnosis;
Disease Progression;
Disease-Free Survival;
Drug Therapy;
Female;
Fever;
Follow-Up Studies;
Humans;
Incidence;
Lymphoma, B-Cell*;
Lymphoma, Non-Hodgkin;
Medical Records;
Mortality;
Oxidoreductases;
Pediatrics;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*;
Recurrence;
Retrospective Studies;
Survival Rate;
Treatment Outcome*
- From:Korean Journal of Pediatric Hematology-Oncology
2005;12(1):28-39
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: High survival rate can be obtained in B-cell lymphoma (Burkitt's lymphoma, diffuse large B-cell lymphoma) and L3 acute lymphoblastic leukemia (ALL) with multiagent chemotherapy. Objectives of this study were to evaluate the treatment outcomes of B-cell lymphoma and L3 ALL diagnosed at the Department of Pediatrics, Asan Medical Center. METHODS: The medical records of 32 children who were diagnosed with Burkitt's lymphoma, diffuse large B-cell lymphoma and L3 ALL from March 1992 to July 2004 at Asan Medical Center were reviewed retrospectively. The 5 year event free survival (EFS) according to the diagnosis, age, risk group and lactic dehydrogenase (LDH) level were analyzed. RESULTS: There were 23 boys and 9 girls. Age ranged from 9 months to 14.4 years old with a median of 7.1 years. Fourteen patients had L3 ALL, 11 had Burkitt's lymphoma and 7 had diffuse large B-cell lymphoma. Five patients (15.6%) had CNS involvement and 5 with B-cell lymphoma (27.8%, 5/18) had BM involvement. All patients who received appropriate chemotherapy achieved a complete remission (CR), but 18.8% (6/32) relapsed. Among 6 relapsed patients, 5 achieved CR after reinduction chemotherapy. One who had no response to secondary chemotherapy and 2 with isolated CNS relapse died due to disease progression. The most common treatment-related toxicity was myelosuppression (87.5%) followed by neutropenic fever (81.3%). Median follow up is 25 months (3 months to 74 months). Four patients who achieved CR after proper induction therapy (4/32, 12.5%) died, 3 due to relapse and 1 due to toxicity-related complication (neutropenia and sepsis). The 5 year EFS for all patients was 77.5+/-7.5% and the 5 year overall survival was 84.6+/-7.3%. The 5 year EFS of B-cell lymphoma compared with that of L3, ALL was 94.4+/-5.4% versus 55.1+/-13.9% (P=0.012) and 5 year overall survival of relapsed patients was 50.0+/-13.9%. CNS disease at diagnosis, age, LDH had no significant influence on EFS. CONCLUSION: High survival rate of childhood B-cell lymphomas and L3 ALL was obtained with recent intensive multiagent chemotherapy and about 50% of relapsed patients were salvaged with reinduction. High incidence of the treatment-related toxicity such as myelosuppression, neutropenic fever and TLS was observed, but the treatment-related mortality was very low with recent supportive therapies. Survival rate was improved with prompt and appropriate management for the treatment-related toxicity of the intensive chemotherapy.
