[Prognostic analysis of childhood T-lymphoblastic lymphoma treated with leukemia regimen]

Area of Science:

• Pediatric Oncology
• Hematology
• Lymphoma Research

Background:

• Childhood T-lymphoblastic lymphoma (T-LBL) is an aggressive subtype of non-Hodgkin lymphoma.
• Treatment often involves regimens designed for acute lymphoblastic leukemia (ALL).
• Understanding prognostic factors is crucial for optimizing T-LBL management.

Purpose of the Study:

• To evaluate the prognosis of childhood T-lymphoblastic lymphoma (T-LBL) treated with acute lymphoblastic leukemia (ALL) chemotherapy regimens.
• To identify factors influencing survival outcomes in pediatric T-LBL patients.

Main Methods:

• Retrospective analysis of 29 pediatric T-LBL patients treated with ALL-2009 or CCCG-ALL-2015 regimens between May 2010 and May 2022.
• Evaluation of prognostic characteristics, including clinical symptoms, laboratory findings, and treatment regimens.

Main Results:

• The 5-year overall survival (OS) and event-free survival (EFS) rates were 84%±7% and 81%±8%, respectively.
• Factors associated with poorer prognosis included B systemic symptoms, platelet count >400×10^9/L, and involvement of both mediastinum and lymph nodes.
• The CCCG-ALL-2015 regimen reduced high-dose methotrexate frequency and severe infections compared to the ALL-2009 regimen without affecting survival rates.

Conclusions:

• Acute lymphoblastic leukemia (ALL) regimens are effective and safe for treating childhood T-lymphoblastic lymphoma (T-LBL).
• Identifying patients with B systemic symptoms, elevated platelet counts, or mediastinal and lymph node involvement is key for predicting poor prognosis.
• Modifying chemotherapy protocols, such as reducing high-dose methotrexate, can decrease infection rates without compromising patient outcomes.