TITLE:
Pediatric Non-Hodgkin Lymphoma: A Retrospective 7-Year Experience in Children & Adolescents with Non-Hodgkin Lymphoma Treated in King Fahad Medical City (KFMC)
AUTHORS:
Nahla Ali Mobark, Suha A. Tashkandi, Wafa Al Shakweer, Khalid Al Saidi, Suha A. Fataftah, Mohammed M. Al Nemer, Awatif Alanazi, Mohammed Rayis, Walid Ballourah, Othman Mosleh, Zaheer Ullah, Fahad El Manjomi, Musa Al Harbi
KEYWORDS:
Non-Hodgkin Lymphoma, Disease, Patients, Children and Adolescents
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.4,
April
8,
2015
ABSTRACT: Background: Non-Hodgkin’s lymphoma is an aggressive malignant
disease in children and adolescents. Although it is the fourth most common
malignancy in Saudi children as reported in Saudi cancer registry, less
information is available about pediatric Non-Hodgkin lymphoma and its outcome
in Saudi Arabia. Study Objectives: To provide demographic data, disease
characteristics, treatment protocol, toxicity and outcome of treatment in
children & adolescents with Non-Hodgkin’s lymphoma treated at KFMC. This
study will form base line for future studies about pediatric Non-Hodgkin’s lymphoma
in KFMC, which may help to improve outcome for children with cancer in Saudi
Arabia. Study Patients and Method: We retrospectively analyzed 28 children and
adolescents diagnosed to have Non-Hodgkin’s lymphoma at KFMC between December
2006 and December 2013, followed-up through June 2014. Results: Of the 28
patients, 10 (35.7%) girls and 18 (64.3%) boys, the male-to-female ratio was
1.8; 1. The median age at time of diagnosis was 6.4 years old (range 2.0 to
13.0 years old). The majority of patients (64.3%) were aged between 5 and 12
years old. Burkitt’s lymphoma BL/BLL was the most common pathological subtype
(60.7%), and DLBCL was the second most common subtype (21.4%). Abdominal and
Retroperitoneal involvement was the most common primary site (78.6%) including
the ileocaecal region. Most of the children presented with advanced Stage III
and IV (75%), Cytogenetic study which screens specifically for the t (8; 14)
(q24; q32) a characteristic genetic feature of Burkitt’s Lymphoma was obtained
from 21 patients, variant rearrangement was observed in 3/21 samples and
complex chromosomes karyotype in addition to IGH/MYC rearrangement was observed
in 2/21 samples. Those patients presented with very aggressive lymphoma and
combined BM and CNS involvement. We use the French-American-British Mature
B-Cell Lymphoma 96 Protocol (FAB LMB 96) for treatment fornewly diagnosed
Mature B-Cell type NHL and high risk ALL CCG 1961 Protocol for lymphoblastic
lymphoma and international Anaplastic Large Cell Lymphoma 99 Study Protocol for
ALCL. The median follow-up in patients not experiencing an adverse event was
53.1 months. The estimated 3-year EFE and OS rates in the entire cohort of
patients with newly diagnosed NHL treated in the KFMC were 85.2% and 89.2%
respectively; Overall survival (OS) rate of patients with mature B-cell-NHL was
88.9%. Conclusion: The outcomes and survival in our small series appeared to be
excellent compared with those reported in other international trials even
though most of our patients presented in advanced stage of the disease. We feel
that the importance of the current study is to document the relative
distribution of various types of pediatric non-Hodgkin’s lymphomas and
age-specific distribution in different Histological subtypes.