科研成果详情

题名A multicenter study on effect of delayed chemotherapy on prognosis of Burkitt lymphoma in children
其他题名A multicenter study on effect of delayed chemotherapy on prognosis of Burkitt lymphoma in children
作者
发表日期2024-10-02
发表期刊Zhonghua er ke za zhi = Chinese journal of pediatrics   影响因子和分区
语种中文
原始文献类型Journal Article ; Multicenter Study ; English Abstract
关键词伯基特淋巴瘤 预后 多中心研究
其他关键词Burkitt lymphoma ; Prognosis ; Multicenter study
摘要Objective: To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis. Methods: Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups. Results: Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old (OR=0.54,95%CI 0.30-0.93), tumor lysis syndrome before chemotherapy (OR=0.48,95%CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy (OR=0.55,95%CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions: The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children
其他摘要Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay 7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.
资助项目Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority[XTZD20180204];Science and Technology Development Program of Jinan Municipal Health Commission[2023-1-57]
ISSN0578-1310
卷号62期号:10页码:941-948
DOI10.3760/cma.j.cn112140-20240210-00106
页数8
收录类别PUBMED ; 万方 ; CSCD ; ISTIC ; 北大核心
URL查看原文
PubMed ID39327960
引用统计
文献类型期刊论文
条目标识符https://kms.wmu.edu.cn/handle/3ETUA0LF/218979
专题第二临床医学院、附属第二医院、育英儿童医院
附属第二医院
第二临床医学院、附属第二医院、育英儿童医院_儿科学
作者单位
1.Department of Hematology & Oncology, Children's Hospital Affiliated to Shandong University(Jinan Children's Hospital), Jinan 250022, China.;
2.Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China.;
3.Department of Pediatric Lymphoma, Beijing GoBroad Boren Hospital, Beijing 100070, China.;
4.Department of Hematology, Hunan Children's Hospital, Changsha 410007, China.;
5.Department of Hematology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.;
6.Department of Hematology & Oncology, Zhengzhou Children's Hospital, Zhengzhou 450018, China.;
7.Department of Hematology & Oncology, Xi'an Children's Hospital, Xi'an 710002, China.;
8.Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.;
9.Department of Pediatric Hematology & Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.;
10.Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China.;
11.Department of Hematology & Oncology, Anhui Children's Hospital, Hefei 230022, China.;
12.Department of Pediatric Hematology & Oncology, the Affiliated Hospital of Qingdao University, Qingdao 266003, China.;
13.Department of Hematology, Children's Hospital, Capital Pediatric Research Institute, Beijing 100020, China.;
14.Department of Pediatrics, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.;
15.Department of Pediatrics, Forth Hospital of Hebei Medical University, Shijiazhuang 050011, China.;
16.Department of Hematology and Oncology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.;
17.Department of Hematology and Oncology, Wuhan Children's Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430016, China.;
18.Department of Pediatric Hematology and Oncology, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430022, China.;
19.Department of Hematology and Oncology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.;
20.Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325024, China.;
21.Department of Hematology, First Affiliated Hospital of Shandong First Medical University, Jinan 250022, China.;
22.Department of Pediatrics, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou 362002, China.;
23.Pathology Department, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.;
24.Department of Pathology, Peking University Third Hospital, Beijing 100191, China.;
25.Pediatric Research Institute, Children's Hospital Affiliated to Shandong University(Jinan Children's Hospital), Jinan 250022, China.
推荐引用方式
GB/T 7714
L Song,L Jin,Y H Zhang,et al. A multicenter study on effect of delayed chemotherapy on prognosis of Burkitt lymphoma in children[J]. Zhonghua er ke za zhi = Chinese journal of pediatrics,2024,62(10):941-948.
APA L Song., L Jin., Y H Zhang., X M Yang., Y L Duan., ... & F Li. (2024). A multicenter study on effect of delayed chemotherapy on prognosis of Burkitt lymphoma in children. Zhonghua er ke za zhi = Chinese journal of pediatrics, 62(10), 941-948.
MLA L Song,et al."A multicenter study on effect of delayed chemotherapy on prognosis of Burkitt lymphoma in children".Zhonghua er ke za zhi = Chinese journal of pediatrics 62.10(2024):941-948.

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