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Abstract
Aim of the work: to investigate and define the extent of the B-cell pediatric NHL in uniform fashion, collect clinico epidemiologic data in all patients and evaluate response to therapy for B- Cell lymphomas.
Patients and methods: this study was carried out in the period between July 2001 and January 2005 at Clinical oncology department Tanta university and Tanta cancer Center. Fourty three children ? 16 years old with pathologically proven NHL, B cell type, and did not receive previous chemotherapy and/or radiotherapy were eligible included in this study. All patients in this study received the same combination regimen they had received alternating cycles of non Cross- resistant drugs. The protocol consisted of 7- drugs., divided into two cycles A and B. Cycls A included cyclophosphmide, adriamycin, vincristine, cytosine arabinoside, plus intrathecal methotrexate and intrathecal cytosine arabinoside. Cycle B consisted of ifosfamide, etposide, methotrexate vincrstine and intrathecal cytosine arabinoside and methotrexate.
Results: the age of the 43 studied patients ranged between 3 and 16 years with a median 5 years. The male to female ratio was 3.8 : 1 According to st. Jude staging system, 7% of patients had stage I , 23.2% stage II, 62.8% stage III and 7% stage IV. Pathological classification in this study was according he REAL classification,. 74.4% of patients had Burkitt’s lymphomas and 25.6 % had large B-cell lymphomas. Complete remission was achieved in 90.2%, 4.9% of patients showed no response and 4.9% showed disease progression. The OS, DFS and EFS at 36 months were 90% , 97% and 83.4% respectively. Correlations between survivals and differentprognostic factors showed that LDH level was the only prognostic variable that had statistically singnificant effect on, EFS and OS of the studied patients.
Conclusions: treatment result of this regimen for B-cell NHL at Clinical oncology department, Tanta university and Tanta Cancer center is good and comparable to those obtained in other studies intermediate dose methotrexate may have a role in improving DFS survival of B- dell NHL LDH level was the only prognostic variable that had statistically significant effect on, EFS and OS of the studied patients.