Treatment outcome of pediatric patients with mature b cell lymphoma receiving Fab LMB96 protocol at the National Cancer Institute, Cairo University

الملخص EN

Introduction: Lymphomas are the third most common malignant tumor in the pediatric age group after leukemia and brain tumors.

Outcome has improved remarkably over the past decade because of improvements in imaging and staging systems that more accurately reflect the clinical behavior, and the development of risk-adapted multi-agent chemotherapeutic regimens.

The aim of this work is to study the outcome, overall Survival (OS) and Event Free Survival (EFS) of patients receiving FAB LMB96 protocol applied for treatment of mature B cell lymphoma.

Patients and Methods : this is a retrospective study analyzing the data of 103 newly diagnosed pediatric NHL [Burkitt’s lymphoma / leukemia, Diffuse Large B Cell Lymphoma (DLBCL)] who received LMB96 protocol at Department of Pediatric Oncology, National Cancer Institute, Cairo University, during the time period from 1st of January 2006 to the end of December 2008.

A total of 103 patients were included in the study, and were followed up till 31st December 2009.

Results : this study included were 80 males (77.7 %).

And 23 females (22.3 %), their mean age was 6.55 ± 3.9 Years ranged from 2 to 16 years.

Abdominal presentation was the most common clinical presentation seen in 85 patients (82.5 %) followed by thoracic mass in 27 patients (26.2 %) and cervical mass in 22 patients (21.4 %).

CNS involvement occurred in 16 patients (15.5 %) while bone marrow infiltration occurred in 18 patients (17.5 %).

The most common pathological subtype was Burkitt’s lymphoma seen in 83 patients (80.6 %) followed by DLBCL in 12 patients (11.7 %).

Stage III was the most commonly seen ; detected in 65 patients (63.1 %).

The commonest treatment group seen was group B in 80 patients (77.7 %) followed by group C in 19 patients (18.4 %) then group A in 4 patients (3.9 %).

Complete remission for the whole group of patients was achieved in 72 patients (70 %), relapses and disease progression occurred in 9 patients (8.7 %) and stable disease in 1 patient (1 %).

Death due to septicemia occurred in 13 patients (12.6 %).

There were 8 patients (7.7 %) who discontinued treatment Conclusion : FAB LMB96 protocol is well tolerated, giving results close to the international literature for both group A and B patients, while it seems toxic for group C patients.