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[Clinical Efficacy and Prognostic Factors of Newly Diagnosed Children[JP] with Burkitt Lymphoma Treated by High-Dose
Bo-Tao Wang1, Hui-Bing Dang1, Yu-Jing Wei2
1Department of Hematology, The First Affiliated Hospital of Nanyang Medical College, Nanyang 473000, Henan Province, China.
Insights
High-dose modified LMB chemotherapy effectively treats pediatric Burkitt lymphoma. Central nervous system involvement and early treatment resistance predict poor outcomes, but Rituximab improves prognosis for high-risk children.
Area of Science:
- Pediatric Oncology
- Hematologic Malignancies
- Lymphoma Research
Background:
- Burkitt lymphoma is an aggressive non-Hodgkin lymphoma with high incidence in children.
- Optimizing treatment regimens is crucial for improving survival rates in pediatric patients.
- The role of Rituximab in conjunction with chemotherapy for Burkitt lymphoma requires further investigation.
Purpose of the Study:
- To evaluate the clinical efficacy of a high-dose, short-course modified LMB regimen ± Rituximab in newly diagnosed pediatric Burkitt lymphoma.
- To identify prognostic factors influencing treatment outcomes in this patient population.
- To provide clinical references for the diagnosis and treatment of pediatric Burkitt lymphoma.
Main Methods:
- Retrospective analysis of 91 newly diagnosed pediatric Burkitt lymphoma patients treated from 2007-2016.
- Treatment involved a high-dose, short-course modified LMB regimen, with Rituximab added for high-risk cases.
- Clinical characteristics, treatment efficacy, and prognostic factors were analyzed.
Main Results:
- Five-year overall survival and event-free survival (EFS) rates were 89.27% and 87.16%, respectively.
- EFS rates varied by risk group: 100% (low-risk), 94.51% (moderate-risk), and 84.60% (high-risk).
- Independent risk factors for poor prognosis included maxillofacial/CNS involvement, early chemotherapy insensitivity, and mid-term tumor burden. Rituximab improved EFS in high-risk patients.
Conclusions:
- The high-dose, short-course modified LMB regimen demonstrates satisfactory clinical efficacy in pediatric Burkitt lymphoma.
- Central nervous system involvement, early treatment insensitivity, and mid-term tumor burden are associated with worse prognosis.
- Adding Rituximab to chemotherapy significantly improves long-term prognosis for high-risk pediatric Burkitt lymphoma patients.
Objective:
To investigate the clinical efficacy and prognostic factors of high-dose and short-course modified LMB regimen ± Rituximab in the treatment of newly diagnosed children with Burkitt lymphoma, soas to provide more reference for clinical diagnosis and treatment with follow-up.
Methods:
91 newly diagnosed children with Burkitt lymphoma treated in our hospital from January 2007 to August 2016 were chosen. High-dose and short-course modified LMB regimen were used to treat children at different risk levels- Rituximab were added in treatment of high-risk group. The clinical characteristics and efficacy of the treatment were analyzed, and the related prognostic factors were evaluated.
Results:
The overall survival rate and event-free survival rate in 5-year with follow-up of 91 children were separately（89.27±2.69）%， （87.16±2.30）%; the event-free survival rate of patients in 5-year with follow-up in low-risk, moderate-risk and high-risk group were separately 100%，（94.51±2.97）%，（84.60±3.40）%. The event-free survival rate in 5-year with follow-up of high-risk group were significantly lower than that of moderate-risk group（P<0.05）. Univariate analysis showed that the combination of maxillofacial and central nervous system invasion, LDH >1000 U/L, proportion of bone marrow tumor cell >25%, organ involvement number >4, St. Jude stage for IV stage, early chemotherapy insensitivity and tumor lesion in mid-term evaluation were risk factor for poor prognosis in newly diagnosed children with Burkitt lymphoma（P<0.05）.Multivariate analysis showed that the combination of maxillofacial and central nervous system invasion, early chemotherapy insensitivity and tumor lesion in mid-term evaluation were the independent risk factor for poor prognosis of children with Burkitt lymphoma（P<0.05）. The EFS rate in 5-year with follow-up of high-risk children treated with chemotherapy+rituximab was significantly higher than that of chemotherapy alone（P<0.05）.
Conclusion:
High-dose and short-course modified LMB regimen in the treatment of newly diagnosed children with Burkitt lymphoma shows satisfactory clinical efficacy. The children with central nervous system involvement, early chemotherapy insensitivity and tumor lesion in mid-term evaluation show the worse prognosis, while Rituximab added is more helpful to improve the long-term prognosis for high-risk children with Burkitt lymphoma.
