Clinical Features and Treatment Outcome of Pediatric Lymphoblastic Lymphoma at South Egypt Cancer Institute | ||
| SECI Oncology Journal | ||
| Volume 11, Issue 4, October 2023, Pages 300-305 | ||
| Abstract | ||
| Background: Lymphoblastic lymphoma (LBL) and acute lymphoblastic leukemia (ALL) are distinct malignancies arising from immature B or T-cell precursors, classified by the World Health Organization. Differentiating them relies on blast cell percentages in bone marrow, often 20-25%. LBL treatment strategies have shifted from high-grade NHL protocols to ALL-based approaches. The study aimed to present the clinical characteristics, overall survival (OS), event-free survival (EFS), and common chemotherapy-related toxicities observed in patients diagnosed with lymphoblastic lymphoma (LBL) over an 8-year period, spanning from January 1st, 2014, to December 31st, 2020. Methods: A retrospective cohort analysis was conducted on a cohort of 29 patients diagnosed with LBL and treated using a modified St. Jude TXIII-B high-risk protocol. Results: The cohort had a mean age of 6.21 ± 3.08 years, with 16 patients (55.2%) being males and 13 patients (44.8%) females. Primary symptoms included difficulty in breathing (51.7%), weight loss (44.8%), peripheral lymph node enlargement (31.0%), fever (31.0%), and pallor (17.2%). All patients presented with advanced-stage disease, with 82.8% at stage III and 17.2% at stage IV. Imaging studies revealed nodal involvement in 31% and extra-nodal involvement in 69% of patients. Hemoglobin levels were ≥ 8 g/dL in 82.8%, kidney function was normal in 72.4%, and 58.6% had LDH levels ≥ 500 U/L. Albumin levels were ≥ 30 mg/dL in 96.6%. Immunophenotyping confirmed T- cell origin (CD3 positive, CD20 negative) in all patients. Bone marrow involvement was observed in 17.2%, and cerebrospinal fluid involvement in 3.4%. Complete remission was achieved in 75.9% of patients, while relapse occurred in 17.2%. Seven patients (24.1%) died, with relapse and severe infection being major contributors. Treatment-related toxicities included myelosuppression (86%), mucositis (62%), and hepatotoxicity (62%). The 4- year OS and EFS were 85 ± 7.5%and 78.6 ±3.4% respectively. Conclusion: The study's findings align with similar research on LBL treatment. Patients with relapse had poor outcomes, emphasizing the need to identify prognostic factors like minimal residual tumors for better chemotherapy response evaluation. The study also noted specific chemotherapy-related side effects, calling for careful treatment planning and management strategies. | ||
| Keywords | ||
| Lymphoblastic lymphoma; clinical features; treatment outcomes; treatment morbidities | ||
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