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首页> 外文期刊>Pediatric blood & cancer >Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)
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Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

机译：中美洲小儿非霍奇金淋巴瘤的结果：中美洲儿科血液学肿瘤学会的报告（AHOPCA）

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Abstract Background Treating B–non‐Hodgkin lymphoma (B‐NHL) in lower‐income countries is challenging because of imprecise diagnosis, the increased risk of fatal toxicity associated with advanced disease at presentation, and limited supportive care. Procedure Central American patients with newly diagnosed stage I or II B‐NHL received a modified Berlin–Frankfurt–Münster (BFM) regimen including a prephase (prednisone, cyclophosphamide) followed by A/B/A courses (A: cytarabine, dexamethasone, etoposide, ifosfamide, methotrexate, and intrathecal therapy; B: cyclophosphamide, dexamethasone, doxorubicin, methotrexate, and intrathecal therapy). Those with stage III or IV NHL received additional courses (B/A/B), intensified for stage IV disease by additional vincristine and methotrexate doses. Patients in poor condition received a second prephase treatment before their chemotherapy courses. Results Between March 2004 and June 2016, of 405 patients with B‐NHL, 386 (109 females) were eligible for treatment. Immunohistochemistry was performed in 177 cases (47.4%) and characterized the disease as mature B‐cell lymphoma. Stage distribution was as follows: I/II, 31 (8.1%); III, 252 (65.3%); IV, 93 (24.1%); 10 (2.6%) not available. The 3‐year overall survival was 70% for the whole group (86% for stages I/II, 75% for stage III, 58% for stage IV). Events included death during induction (34 patients, 8.8%), relapse/progression (46, 11.9%), death in remission (9, 2.3%), second malignancy (1, 0.26%), and death of unknown cause (1, 0.26%). Twenty‐three (6%) patients abandoned or refused therapy. Conclusions Approximately 70% of children with B‐NHL from Central America experienced long‐term, disease‐free survival with a modified BFM schedule. Toxic death and relapse/resistant disease were the main reasons for treatment failure.
机译：摘要背景下，低收入国家的B-非霍奇金淋巴瘤（B-NHL）是挑战，因为诊断不精确，致命毒性的风险增加，伴随着先进疾病，以及有限的支持性护理。程序中美洲新诊断阶段的患者I或II B-NHL接受了一种改进的Berlin-Frankfurt-Münster（BFM）方案，包括静脉（泼尼松，环磷酰胺），其次是A / B / A课程（A：含有半藻，地塞米松，依托泊苷，Ifosfamide，甲氨蝶呤和鞘内治疗; B：环磷酰胺，地塞米松，多柔比星，甲氨蝶呤和鞘内治疗）。具有阶段III或IV NHL的那些，通过额外的长春杂细胞和甲氨蝶呤剂量加入额外的疗程（B / A / B），促进阶段IV疾病。病情差的患者在化疗课程之前接受了第二次静脉检查。结果2004年3月至2016年6月，405例B-NHL患者，386名（109名女性）有资格进行治疗。免疫组织化学在177例（47.4％）中进行，并表征疾病是成熟的B细胞淋巴瘤。阶段分布如下：I / II，31（8.1％）; III，252（65.3％）; IV，93（24.1％）; 10（2.6％）不可用。整个组的3年整体存活率为70％（阶段I / II的阶段I / II的86％，阶段III的75％，第四阶段58％）。事件包括在诱导期间死亡（34名患者，8.8％），复发/进展（46,11.9％），缓解死亡（9,2.3％），第二个恶性肿瘤（1,0.26％）和未知原因的死亡（1， 0.26％）。二十三（6％）患者被遗弃或拒绝治疗。结论大约70％的儿童来自中美洲的B-NHL经历了长期的无病生存，并进行了改进的BFM时间表。毒性死亡和复发/抗性疾病是治疗失败的主要原因。

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