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Clinical features and treatment results of children with diffuse large B-cell lymphoma
Erman Ataş1, M Tezer Kutluk, Canan Akyüz
1Department of Pediatric Oncology, Hacettepe University Faculty of Medicine , Ankara , Turkey.
Insights
Pediatric diffuse large B-cell lymphoma (DLBCL) is rare but increasing. Early diagnosis and prompt referral are crucial for improving survival rates in children with DLBCL, especially those with advanced disease or comorbidities.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Diffuse large B-cell lymphoma (DLBCL) is a subtype of non-Hodgkin lymphoma (NHL).
- The incidence of pediatric DLBCL has increased in recent years.
- Understanding the characteristics and outcomes of pediatric DLBCL is essential for improving patient care.
Purpose of the Study:
- To analyze the demographic and clinical characteristics of pediatric DLBCL cases.
- To evaluate treatment outcomes and survival rates in children with DLBCL.
- To identify prognostic factors influencing survival in pediatric DLBCL.
Main Methods:
- Retrospective analysis of 33 pediatric DLBCL cases from 1486 NHL cases since 1972.
- Kaplan-Meier methods and logrank tests for survival analysis.
- Multivariate analysis to identify prognostic factors.
Main Results:
- Pediatric DLBCL accounted for 2.2% of NHL cases, increasing to 9.3% after 2000.
- Five-year event-free survival (EFS) and overall survival (OS) were 61% and 65.1%, respectively.
- Advanced stage disease, older age (>14 years), and associated conditions were poor prognostic factors.
Conclusions:
- Survival rates for pediatric DLBCL require improvement.
- Late referral and advanced disease at diagnosis are significant challenges.
- Early diagnosis, prompt referral, and careful management of high-risk patients are critical for better outcomes.
Abstract:
The demographic, clinical characteristics, and treatment groups of 33 children with diffuse large B-cell lymphoma (DLBCL) were recorded and analyzed among 1486 non-Hodgkin lymphoma (NHL) cases since 1972. The median age was 9.7 years (range 1.4-16.9) and male/female ratio was 24/9 = 2.6. Kaplan-Meier methods and logrank tests were used in treatment analysis. The frequency of DLBCL among 1486 NHL cases was 2.2%, however, the percentage was 9.3% in cases diagnosed after 2000. The event-free survival (EFS) and overall survival (OS) rates for 33 children were 61% and 65.1% at 5 years, respectively. The EFS and OS rates of low stage (stages I and II) disease decreased to lower level in advanced stage (stages III and IV) disease. Associated conditions and ages older than 14 years were found as poor prognostic factors in multivariate analysis. The survival rates in children with DLBCL need further improvement. This is mainly related with late referral of those children with advanced disease. The proper diagnosis and early referral is essential in these children for a better survival rate. The children with associated conditions and older children must be handled with care since these are found as poor prognostic factors.
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