PROGNOSIS OF PEDIATRIC NON HODGKIN LYMPHOMAS TREATED WITH FAB/LMB96 IN TERTIARY CENTER, SAUDI ARABIA

Authors

  • Moussa Mohamed Shehadah
  • Khalid Abdalla Abdalla
  • Omima Abdullah Mustafa
  • Naglla Elimam
  • Abdullah A. Baothman

DOI:

https://doi.org/10.47672/ajhmn.562
Abstract views: 311
PDF downloads: 187

Keywords:

Survival, Pediatric, Lymphomas, Non Hodgkin lymphoma.

Abstract

Purpose: This study aimed at describing prognosis of pediatric B-NHL patients treated with FAB LMB-96 based protocol without dose modification, and to identify possible prognostic factors influencing the outcome and the treatment related toxicities.

Methodology: Through a retrospective study design, the researchers traced 48 pediatric cases who had been diagnosed with Mature B-NHL and treated at Prince Nora Oncology Center (PNOC) in the period from January 2007 to December 2016.  Data were retrieved from the medical records, radiology images and pathology specimen for cases who met the inclusion criteria. For operational definition, cases were defined according to WHO classification, while staging was performed according to Murphy’s classification. Kaplan Meier survival function analysis was used to determine overall survival and Event Free Survival; and Chi Square test was used to verify significance in the differences according to characteristics of the cases.  

Findings: Out of all cases (n=48), Saudis formed (85.4%) and male to female ratio was 2.4:1, with a median age at diagnosis of 5.6 years. Most of the cases were diagnosed as Burkitt’s lymphoma (87.5%), mainly in stage III (37.5%) and stage IV (39.6%), chiefly as primary abdominal retro-peritoneal tumors (47.9%). Almost all cases (97.9%) developed chemotherapy related hematologic toxicity and fever neutropenia, and one third (34.8%) had septic shock. At the end of follow-up (median=112 months), there were 40 patients (83.3%) achieved remission, out of them, 6 (12.5%) relapsed. Death was attributed to disease recurrence (3 cases) and treatment related toxicities (4 patients). No statistically significant difference detected in the overall and Event Free survival rates according to their age, gender, histology, biochemical markers, disease locations, staging and FAB group classifications (P >0.05).

Conclusion and recommendations: Childhood non-Hodgkin lymphomas are almost all high grade and frequently extranodal. They fall mainly into the categories Burkitt lymphoma, lymphoblastic lymphoma and anaplastic large cell lymphoma. Our findings are comparable with those reported in other international trials

Downloads

Download data is not yet available.

Author Biographies

Moussa Mohamed Shehadah

 

Associate consultant of Pediatric Hematology and Oncology.

Department of oncology

Ministry of National Guard-Health Affairs,

Jeddah, Saudi Arabia

King Abdullah International Medical Research Center

Jeddah, Saudi Arabia

Khalid Abdalla Abdalla

 

Consultant of Pediatrics Hematology and oncology

Department of oncology

Ministry of National Guard-Health Affairs,

Jeddah, Saudi Arabia

King Abdullah International Medical Research Center

Jeddah, Saudi Arabia

Omima Abdullah Mustafa

Associate consultant of Pediatrics Hematology and Oncology.

Department of oncology

Ministry of National Guard-Health Affairs,

Jeddah, Saudi Arabia

King Abdullah International Medical Research Center

Jeddah, Saudi Arabia

Naglla Elimam

 

Consultant of Pediatrics Hematology and Oncology

Department of oncology

Ministry of National Guard-Health Affairs,

Jeddah, Saudi Arabia

King Abdullah International Medical Research

Jeddah, Saudi Arabia

Abdullah A. Baothman

 

Consultant of Pediatrics Hematology and oncology

Department of oncology

Ministry of National Guard-Health Affairs,

Jeddah, Saudi Arabia

Assistant professor of pediatrics

King Saud Bin Abdulaziz University for Health Science

 Jeddah, Saudi Arabia

King Abdullah International Medical Research

Jeddah- SAUDIA Arabia

 

References

Akhtar, S. S., Haque, I. U., Wafa, S. M., El-Saka, H., Saroor, A. M., & Nadrah, H. M. (2009). Malignant lymphoma in Al-Qassim, Saudi Arabia, reclassified according to the WHO classification. Saudi Medical Journal, 30(5), 677–681.

Belgaumi, A. F., Pathan, G. Q., Siddiqui, K., Ali, A. A., Al‐Fawaz, I., Al‐Sweedan, S., Ayas, M., & Al‐Kofide, A. A. (2019). Incidence, clinical distribution, and patient characteristics of childhood cancer in Saudi Arabia: A population‐based analysis. Pediatric Blood & Cancer, 66(6), e27684.

Burkhardt, B., Zimmermann, M., Oschlies, I., Niggli, F., Mann, G., Parwaresch, R., Riehm, H., Schrappe, M., & Reiter, A. (2005). The impact of age and gender on biology, clinical features and treatment outcome of non-Hodgkin lymphoma in childhood and adolescence. British Journal of Haematology, 31(1), 39–49.

Cairo, M. S., Gerrard, M., Sposto, R., Auperin, A., Pinkerton, C. R., Michon, J., Weston, C., Perkins, S. L., Raphael, M., McCarthy, K., & Patte, C. (2007). Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents. Blood, 109(7), 2736–2743.

Cairo, M. S., Sposto, R., Gerrard, M., Auperin, A., Goldman, S. C., Harrison, L., Pinkerton, R., Raphael, M., McCarthy, K., Perkins, S. L., & Patte, C. (2012). Advanced stage, increased lactate dehydrogenase, and primary site, but not adolescent age ( ≥15 years), are associated with an increased risk of treatment failure in children and adolescents with mature B-cell non-Hodgkin’s lymphoma: Results of the FAB LM. Journal of Clinical Oncology, 30(4), 387–393.

Coiffier, B., Mounier, N., Bologna, S., Fermé, C., Tilly, H., Sonet, A., Christian, B., Casasnovas, O., Jourdan, E., Belhadj, K., & Herbrecht, R. (2003). Efficacy and safety of rasburicase (recombinant urate oxidase) for the prevention and treatment of hyperuricemia during induction chemotherapy of aggressive non-Hodgkin’s lymphoma: Results of the GRAAL1 (Groupe d’Etude des Lymphomes de l’Adulte Trial on R. Journal of Clinical Oncology, 21(23), 4402–4406. https://doi.org/10.1200/JCO.2003.04.115

Ferreira, J. M. de O., Klumb, C. E., Reis, R. de S., Santos, M. de O., Oliveira, J. F. P., de Camargo, B., & Pombo-de-Oliveira, M. S. (2012). Lymphoma subtype incidence rates in children and adolescents: First report from Brazil. Cancer Epidemiology, 63(4), e221-6.

Gerrard, M., Cairo, M. S., Weston, C., Auperin, A., Pinkerton, R., Lambilliote, A., Sposto, R., McCarthy, K., Lacombe, M. J. T., Perkins, S. L., & Patte, C. (2008). Excellent survival following two courses of COPAD chemotherapy in children and adolescents with resected localized B-cell non-Hodgkin’s lymphoma: Results of the FAB/LMB 96 international study. British Journal of Haematology, 141(6), 840–847.

Gurney JC, Smith MA, Bunin GR, et al. (1999). Cancer Incidence and Survival among Children and Adolescents: United States SEER Program. In National Cancer Institute SEER Program.

Hochberg, J., Waxman, I. M., Kelly, K. M., Morris, E., & Cairo, M. S. (2009). Adolescent non-Hodgkin lymphoma and Hodgkin lymphoma: state of the science. British Journal of Haematology, 144(1), 24–40.

Mbulaiteye, S. M., Biggar, R. J., Bhatia, K., Linet, M. S., & Devesa, S. S. (2009). Sporadic childhood Burkitt lymphoma incidence in the United States during 1992-2005. Pediatric Blood and Cancer, 53(3), 366–370.

Mobark, N. A., Tashkandi, S. A., Shakweer, W. Al, Saidi, K. Al, Fataftah, S. A., Nemer, M. M. Al, Alanazi, A., Rayis, M., Ballourah, W., Mosleh, O., Ullah, Z., Manjomi, F. El, & Harbi, M. Al. (2015). Pediatric Non-Hodgkin Lymphoma: A Retrospective 7-Year Experience in Children & Adolescents with Non-Hodgkin Lymphoma Treated in King Fahad Medical City (KFMC). Journal of Cancer Therapy, 6, 299–314.

Mwanda, W. O., Orem, J., Remick, S. C., Rochford, R., Whalen, C., & Wilson, M. L. (2005). Clinical characteristics of Burkitt’s lymphoma from three regions in Kenya. East African Medical Journal, 82(9), 135–143.

Nakagawa, A., Nakamura, S., Nakamine, H., Yoshino, T., Takimoto, T., Horibe, K., & Ueda, K. (2004). Pathology review for paediatric non-Hodgkin’s lymphoma patients in Japan: A report from the Japan association of childhood leukaemia study (JACLS). European Journal of Cancer, 40(5), 725–733.

Naresh, K. N., Agarwal, B., Nathwani, B. N., Diebold, J., McLennan, K. A., Muller-Hermelink, K. H., Armitage, J. O., & Weisenburger, D. D. (2004). Use of the World Health Organization (WHO) classification of non-Hodgkin’s lymphoma in Mumbai, India: A review of 200 consecutive cases by a panel of five expert hematopathologists. Leukemia and Lymphoma, 45(8), 1569–1577.

Patte, C., Auperin, A., Gerrard, M., Michon, J., Pinkerton, R., Sposto, R., Weston, C., Raphael, M., Perkins, S. L., McCarthy, K., & Cairo, M. S. (2007). Results of the randomized international FAB/LMB96 trial for intermediate risk B-cell non-Hodgkin lymphoma in children and adolescents: it is possible to reduce treatment for the early responding patients. Blood, 109(7), 2773–2780.

Pedrosa, M. F., Pedrosa, F., Lins, M. M., Neto, N. T. P., & Falbo, G. H. (2007). Non-Hodgkin’s lymphoma in childhood: clinical and epidemiological characteristics and survival analysis at a single center in Northeast Brazil. Jornal de Pediatria, 83(6), 547–554.

Sandlund, J. T., Downing, J. R., & Crist, W. M. (1996). Non-Hodgkin’s lymphoma in childhood. New England Journal of Medicine, 334(19), 1238–1248.

Sandlund, J. T., & Martin, M. G. (2016). Non-Hodgkin lymphoma across the pediatric and adolescent and young adult age spectrum. Hematology, 2016(1), 589–597.

Saudi Health Council. (2015). Cancer Incidence Report, Saudi Arabia, 2015.

Srinivas, V., Soman, C. S., & Naresh, K. N. (2002). Study of the distribution of 289 non-hodgkin lymphomas using the WHO classification among children and adolescents in India. Medical and Pediatric Oncology, 39(1), 40–43.

Swerdlow, S. H., Campo, E., Harris, N. L., Jaffe, E. S., Pileri, S. A., Stein, H., Thiele, J., & Vardiman, J. . (2017). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France. World Health Organization Calssification of Tumours of Haematopoietic and Lymphoid Tissue, 2.

Temmim, L., Baker, H., Amanguno, H., Madda, J. P., & Sinowatz, F. (2004). Clinicopathological features of extranodal lymphomas: Kuwait experience. Oncology, 67(5–6), 382–389.

Wössman, W., Schrappe, M., Meyer, U., Zimmermann, M., & Reiter, A. (2003). Incidence of tumor lysis syndrome in children with advanced stage Burkitt’s lymphoma/leukemia before and after introduction of prophylactic use of urate oxidase. Annals of Hematology, 82(3), 160–165.

Wright, D., McKeever, P., & Carter, R. (1997). Childhood non-Hodgkin lymphomas in the United Kingdom: Findings from the UK Children’s Cancer Study Group. Journal of Clinical Pathology, 50(2), 128–134.

Downloads

Published

2020-08-29

How to Cite

Shehadah, M. M., Abdalla, K. A., Mustafa, O. A., Elimam, N., & Baothman, A. A. (2020). PROGNOSIS OF PEDIATRIC NON HODGKIN LYMPHOMAS TREATED WITH FAB/LMB96 IN TERTIARY CENTER, SAUDI ARABIA. American Journal of Health, Medicine and Nursing Practice, 5(2), 67 - 82. https://doi.org/10.47672/ajhmn.562

Issue

Section

Articles