临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (5): 326-.doi: 10.3969/j.issn.1000-3606.2018.05.002

• 血液肿瘤疾病专栏 • 上一篇    下一篇

儿童恶性淋巴瘤 60 例临床分析

王毓, 张乐萍, 左英熹   

  1. 北京大学人民医院儿科(北京 100044)
  • 收稿日期:2018-05-15 出版日期:2018-05-15 发布日期:2018-05-15
  • 通讯作者: 张乐萍 E-mail:zhangleping@pkuph.edu.cn

Clinical analysis of 60 cases of childhood malignant lymphoma

 WANG Yu,ZHANG Leping,ZUO Yingxi   

  1. Department of Pediatrics, Peking University People 's Hospital,Beijing 100044, China
  • Received:2018-05-15 Online:2018-05-15 Published:2018-05-15

摘要: 目的 探讨儿童恶性淋巴瘤的临床特征、疗效及预后的影响因素。方法 回顾分析近10年收治的60例淋巴 瘤患儿的临床资料,患儿按照WHO淋巴组织肿瘤分类标准和St. Jude分期系统进行分类、分期,并进行比较和分析。结果  60例患儿中男43例、女17例,中位发病年龄8岁(6个月~15岁)。 因局部肿物就诊者最多(21例,35.0%),骨髓及中枢 神经系统受累比例分别为63.3%和6.7%。霍奇金淋巴瘤(HL)与非霍奇金淋巴瘤(NHL)分别占8.3%、91.7%。HL均为 经典型霍奇金淋巴瘤,NHL常见类型包括淋巴母细胞性淋巴瘤、Burkitt淋巴瘤/白血病、间变性大细胞淋巴瘤及弥漫性大 B细胞淋巴瘤。根据St. Jude分期,晚期(Ⅲ~Ⅳ期)57例,占95.0%;疾病进展/复发8例,发生事件中位时间为14个月(6~84 个月)。 患儿5年总生存率为(78±6)%,其中HL与NHL的5年总生存率分别为100%、( 76±8)%,两组间差异无统计学 意义(P=0.270)。COX分析显示,性别(P=0.038)是影响预后的独立因素。结论 儿童淋巴瘤以男性多见,学龄期相对高 发,就诊时多为晚期,以NHL多见。女性是影响预后的不良因素。

Abstract:  Objective To summarize the clinical and biological characteristics and to analyze the prognosis of childhood lymphoma. Methods Clinical data of 60 patients diagnosed as lymphoma during the past ten years were retrospectively studied. All cases were classified according to the WHO classification criteria of lymphoma and the St. Jude staging system. Results Of all the 60 patients, the ratio of male to female was 2.5: 1. The median age was 8 years old (range from 6 months to 15 years). Localized mass was the most common chief complaint for first consultation accounting for 35.0%。 The proportion of the bone marrow and central nervous system involvement was 63.3% and 6.7%, respectively. Hodgkin lymphoma (HL) and non- Hodgkin lymphoma (NHL) counted for 8.3% and 91.7%, respectively. All HL were classified as CHL. As to NHL, LBL, BL/ B-ALL, ALCL, and DLBCL were the main types. According to St. Jude staging, the advanced stage accounted for 95.0%. There were 8 cases with progressive disease/relapse with median time of 14 months (ranged from 6 months to 84 months). 6. In all patients, the 5-year anticipated overall survival (OS) rate was (78%±6%); the 5-year OS for HL and NHL were 100% vs (76%±8%). The survival rate of the two groups showed no significant difference (P=0.270). Cox multivariate analysis indicated that sex (P=0.038) was independent prognostic factors. Conclusions Pediatric lymphoma occurred more in male than in female, peaked at school age. The main histologic type was NHL. Most patients were diagnosed as advanced stage. By gender, female is a poor factor that affects prognosis.