Table of Contents

HK J Paediatr (New Series)
Vol 2. No. 2, 1997

HK J Paediatr (New Series) 1997;2:123-128

Original Article

Paediatric Non-Hodgkin's Lymphoma: The Current Experience at the Queen Mary Hospital and a Review of the Literature

GCF Chan, SY Ha, ACW Lee, DCK Chiu, MY Cheng, YL Lau


Abstract

Non-Hodgkin's lymphoma (NHL) is a common group of paediatric malignant tumours. It usually presents in 3 forms in children, namely (1) small non-cleaved cell (SNCC); (2) lymphoblastic (LB) and (3) large cell (LC) NHL. Their clinical presentation and response to treatment differ from each other but all are highly aggressive. Between January 86 and December 96, 21 patients were diagnosed to have NHL in the Paediatric Unit of Queen Mary Hospital. Nineteen of them received treatment by us and their data were analyzed. Four had SNCC; 5 had LB and 10 had LC (4/10 had Ki-1 positive NHL) NHL. The median age at presentation was 8.5 years and most (13/19) were male. Advanced stage (Stage III & IV) disease was found in 14/19 (74%) patients. The primary site of the disease depended on its histologic form and abdominal or thoracic origin was more common (9/19). Eleven of 19 were treated according to the UKCCSG-NHL protocol. The overall survival was 80% and event free survival (EFS) was 65%. The overall and event free survival (EFS) for early stage (stage I & II) disease were both 100%, and was 76% and 58% for advanced stage (stage III & IV) disease respectively. According to histologic type, the EFS was 100% (SNCC); 45% (LB) and 75% (LC) respectively. Patients who suffered from relapse were all from the lymphoblastic (n=3) or large cell NHL groups (n=2). Two patients with Burkitt's lymphoma developed therapy-related cardiac complication and one required regular anti-failure treatment. The prognosis of paediatric NHLs are related to histology and clinical stage, both of which reflect differences in tumour biology. Current direction in management is to decrease treatment toxicity in the good risk group and to increase treatment intensity in the high risk group; this approach demands accurate diagnosis and staging process.

Keyword : Biology; Chemotherapy; Children; Non-Hodgkin's Lymphoma


Abstract in Chinese

 
 

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