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Pediatric lymphoma: a 10-year experience at a tertiary care hospital in Pakistan
Zehra Fadoo1, Asim Belgaumi, Matloob Alam
1Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan. zehra.fadoo@aku.edu
Insights
Childhood lymphoma, the third most common pediatric cancer, shows varied outcomes. This study highlights survival rates for non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma in Pakistani children, emphasizing the need for improved awareness and care.
Area of Science:
- Pediatric Oncology
- Hematology
- Cancer Epidemiology
Background:
- Lymphoma is a significant childhood malignancy, yet data from certain regions remain limited.
- Understanding local patterns of childhood lymphoma is crucial for improving patient outcomes.
Purpose of the Study:
- To describe the experience of childhood lymphoma at a single institute in Pakistan.
- To analyze the characteristics, treatment, and survival of pediatric lymphoma patients.
Main Methods:
- Retrospective study of children (<15 years) diagnosed with lymphoma between 1998 and 2007.
- Data collection included patient demographics, histopathology, presenting features, and outcomes.
- Survival rates for non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma were calculated.
Main Results:
- Sixty-eight pediatric lymphoma cases were identified: 51 NHL and 17 Hodgkin lymphoma.
- Burkitt lymphoma was the most common NHL subtype (55%); mixed cellularity was the most common Hodgkin lymphoma subtype (65%).
- Overall survival was 62% for NHL and 94% for Hodgkin lymphoma; higher rates of advanced stage and male predominance were noted in NHL.
Conclusions:
- Significant differences in survival exist between pediatric NHL and Hodgkin lymphoma.
- Factors like abandonment of treatment, delayed referral, and inadequate supportive care impact outcomes.
- Increased awareness and improved management strategies are essential for enhancing survival rates in childhood lymphoma.
Summary:
Lymphoma is the third most common childhood malignancy. Less information is available on this disease and its outcome from our country. We present here a single institute experience. A retrospective study was carried out at Aga Khan University Hospital, Karachi on children (<15 y) diagnosed with lymphoma from 1998 to 2007. Sixty-eight patients were identified. Fifty-one children were diagnosed as non-Hodgkin lymphoma (NHL). Mean age of presentation was 8.4 years with male-to-female ratio of 5.8 : 1. Most common histopathologic subtype of NHL was Burkitt lymphoma (55%). Abdominal mass was the main presenting feature of Burkitt and diffuse large B cell lymphoma. T-lymphoblastic lymphoma presented mainly as mediastinal mass. Ten children died, 4 secondary to tumor lysis syndrome, 5 because of disease progression, and 1 with chemotherapy-induced toxicity. One-third of the patients left without treatment. Seventeen children were diagnosed as Hodgkin lymphoma with mixed cellularity as the commonest subtype (65%). Overall survival of children with NHL and Hodgkin lymphoma was 62% and 94%, respectively. A greater proportion of NHL, advanced stage, and profound male preponderance were observed. Improvement in survival can only be achieved with increasing awareness, identifying and tackling causes of abandonment, early referral, and better supportive care.
