Impact of tumor lysis syndrome on the prognosis of pediatric mature B-cell lymphoma
10.3760/cma.j.cn121090-20240624-00234-1
- VernacularTitle:肿瘤溶解综合征对儿童成熟B细胞淋巴瘤预后的影响
- Author:
Chenggong ZENG
1
;
Zhiqing WEI
1
;
Junting HUANG
1
;
Jia ZHU
1
;
Feifei SUN
1
;
Juan WANG
1
;
Suying LU
1
;
Yizhuo ZHANG
1
;
Xiaofei SUN
1
;
Zijun ZHEN
1
Author Information
1. 中山大学肿瘤防治中心儿童肿瘤科，华南恶性肿瘤防治全国重点实验室，广东省鼻咽癌诊治研究重点实验室，广东省恶性肿瘤临床医学研究中心，广州 510060
- Publication Type:Journal Article
- Keywords:
B-cell lymphoma;
Child;
Adolescent;
Tumor lysis syndrome;
Prognosis
- From:
Chinese Journal of Hematology
2024;45(12):1098-1105
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to investigate the effect of tumor lysis syndrome (TLS) on the prognosis of children and adolescents with intermediate- or high-risk high-grade mature B-cell nonHodgkin lymphoma (HG B-NHL) .Methods:This study collected the clinical data and prognosis of 283 patients aged <18 years with newly diagnosed intermediate- or high-risk HG B-NHL treated at the Sun Yat-sen University Cancer Center from January 2010 to December 2022. The clinical characteristics, laboratory indicators during TLS, and prognosis of the patients were analyzed. The optimal cutoff values of laboratory indicators during TLS were identified using R studio according to event-free survival (EFS) .Results:Of the 283 patients enrolled, the median age was 7 (range: 1-18) years and the male-to-female ratio was 3.6∶1, 76 (26.9%) developed TLS, and 207 (73.1%) did not. Patients with TLS demonstrated higher proportions of the pathological subtype Burkitt lymphoma, high-risk stratification, age <12 years, and LDH of ≥1 000 IU/L compared with patients without TLS (all P<0.05). The 5-year EFS and overall survival (OS) rates of the entire group were (84.5±2.2) % and (88.2±2.0) %, respectively. The 5-year OS rate of patients with TLS was significantly lower than that of those without TLS [ (80.8±4.6) % vs (91.0±2.0) %, P=0.01]. Among patients with TLS, those with serum uric acid of ≤612.7 μmol/L ( n=36) exhibited lower 5-year EFS [ (67.8±8.1) % vs (87.5±5.2) %, P=0.04] and OS rates [ (69.9±8.1) % vs (90.0±4.7) %, P=0.04] compared with those with uric acid of >612.7 μmol/L ( n=40). Similarly, patients with serum phosphate of ≤1.89 mmol/L ( n=58) demonstrated lower 5-year EFS [ (71.6±6.0) % vs 100%, P=0.02] and OS rates [ (74.8±5.8) % vs 100%, P=0.03] compared with those with phosphate of >1.89 mmol/L ( n=18) . Conclusions:TLS is associated with poor prognosis in patients with HG B-NHL. Patients with lower serum uric acid and phosphate levels during TLS demonstrated worse prognoses, indicating their potential value in predicting prognosis and guiding stratified treatment.
