Bowel Obstruction and Perforation in Pediatric Intestinal Mature B Cell Lymphoma: Incidence, Clinical Features, and Outcome in CCHE
Cancer Research Journal
Volume 7, Issue 2, June 2019, Pages: 45-52
Received: Mar. 19, 2019;
Accepted: Apr. 17, 2019;
Published: May 26, 2019
Views 150 Downloads 29
Samah Fathy Semary, Department of Clinical Oncology, Faculty of Medicine, Beni - Suef University, Beni- Suef, Egypt; Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
Hany Abdel Rahman, Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt; Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
Gehad Ahmed, Department of Surgery, Helwan University, Cairo, Egypt; Department of Surgery, Children Cancer Hospital Egypt, Cairo, Egypt
Naglaa El Kenaie, Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt; Department of Pathology, Children Cancer Hospital Egypt, Cairo, Egypt
Marwa Romeih, Department of Radio-Diagnosis, Helwan University, Cairo, Egypt; Department of Radio–Diagnosis, Children Cancer Hospital Egypt, Cairo, Egypt
Rana Mohy, Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt
Nouran Nagi, Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt
Follow on us
Bowel perforation or obstruction is life-threatening complications of intestinal lymphoma. Our aim was to define incidence, clinical features, and outcome associated with bowel perforation or obstruction in pediatric intestinal lymphoma. A retrospective, non-randomized study was included all newly diagnosed pediatric intestinal mature B cell lymphoma patients who were operated out of intestinal obstruction or perforation from July 2007 till July 2017 in CCHE. The results showed that, intestinal obstruction or perforation developed in 34 patients (7.5%) out of 456 patients with intestinal mature B cell lymphoma. Median age is 4.85 years. All of them were treated accordingly to NHL LMB 96 protocol . The 5 years OS among patients were operated out of intestinal obstruction, and who were operated out of perforation were 87.7%, 62.9% respectively with no significant statistical differences. Five years OS among patients with viable malignant cell versus no malignant cell was 65.2%, 90.9% respectively with significant P value. The five years OS for patients didn’t have surgery, and who had surgery was 87.9%, 78.6%, respectively, with no significant statistical differences. Multivariate analysis on EFS and OS was done for the overall group and the subgroup. Including age, sex, pathology, clinical stage, elevated LDH, presence of ATLS, showed statically no significance. In Conclusion, Intestinal complication in the form of obstruction with or without intussusception, or obstruction perforation followed by exploration is not adverse prognostic factor for survival in pediatric patients with intestinal mature B cell lymphoma. Operation with viable malignant cell was associated with significant lower outcome.
Bowel Obstruction, Bowel Perforation, Prognostic Factors, Pediatric Intestinal Mature B Cell Lymphoma
To cite this article
Samah Fathy Semary,
Hany Abdel Rahman,
Naglaa El Kenaie,
Bowel Obstruction and Perforation in Pediatric Intestinal Mature B Cell Lymphoma: Incidence, Clinical Features, and Outcome in CCHE, Cancer Research Journal.
Vol. 7, No. 2,
2019, pp. 45-52.
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Mitchell S. Cairo, Mary Gerrard, Richard Sposto, et al on behalf of the FAB LMB96 International Study Committee, Results of a randomized international study of high-risk central nervous system B non-Hodgkin lymphoma and B acute lymphoblastic leukemia in children and adolescents, Blood 2007 109:2736-2743; doi: https: //doi.org/10.1182/blood-2006-07-036665.
David M. Biko1, Sudha A. Anupindi2, Andrea Hernandez2, et al, Childhood Burkitt Lymphoma: Abdominal and Pelvic Imaging Findings, American Journal of Roentgenology. 2009; 192: 1304-1315. 10.2214/AJR.08.1476
A Shad, I Magrath: Malignant non-Hodgkin's lymphomas in children.PA Pizzo, DG Poplack (Eds.), Principles and Practice of Pediatric Oncology, Lippincott-Raven Publishers, Philadelphia, PA (1997), pp. 545-587.
Vaidya R1, Habermann TM, Donohue JH, et al, Bowel perforation in intestinal lymphoma: incidence and clinical features. Ann Oncol. 2013 Sep; 24 (9): 2439-43.
Bethel CA, Bhattacharyya N, Hutchinson C, Ruymann F, Cooney DR. Alimentary tract malignancies in children. J Pediatr Surg. 1997; 32: 1004–8.
G.W.van ImhoffaI.M.AppelcN.J.G.M.Veegerd, et al, Gender and age-related differences in Burkitt lymphoma – epidemiological and clinical data from The Netherlands, European Journal of Cancer Volume 40, Issue 18, December 2004, Pages 2781-2787.
Mitchell S. Cairo, Richard Sposto, Mary Gerrard, et al, Advanced Stage, Increased Lactate Dehydrogenase, and Primary Site, but Not Adolescent Age (≥ 15 Years), Are Associated With an Increased Risk of Treatment Failure in Children and Adolescents With Mature B-Cell Non-Hodgkin's Lymphoma: Results of the FAB LMB 96 Study, J Clin Oncol. 2012 Feb 1; 30 (4): 387–393.
Ladd AP, Grosfeld JL. Gastrointestinal tumors in children and adolescents. Semin Pediatr Surg. 2006; 15: 37–47.
Morsi A, Abd El-Ghani Ael-G, El-Shafiey M, Fawzy M, Ismail H, Monir M. Clinico-pathological features and outcome of management of pediatric gastrointestinal lymphoma. J Egypt Natl Canc Inst. 2005; 17: 251–9.
Ranjana Bandyopadhyay, Swapan Kumar Sinha,1 Uttara Chatterjee,1, et al, Primary pediatric gastrointestinal lymphoma. Indian J Med Paediatr Oncol. 2011 Apr-Jun; 32 (2): 92–95.
Véronique Minard-Colin, Laurence Brugières, Alfred Reiter, Non-Hodgkin Lymphoma in Children and Adolescents: Progress Through Effective Collaboration, Current Knowledge, and Challenges Ahead. J Clin Oncol. 2015 Sep 20; 33 (27): 2963–2974.
Galleze A 1 2 Raache R 1 2 Cherif N, et al. Increased Level of Lactate Dehydrogenase Correlates with Disease Growth in Algerian Children with Lymphoma. Journal of Hematology and Oncology Research, ISSN: 2372-6601, Volume No: 2 Issue No: 4.
Huang S1, Yang J, Zhang R, et al, [Clinical analysis of 18 cases with acute tumor lysis syndrome in children with B-cell lymphoma]. Zhonghua Er Ke Za Zhi. 2011 Aug; 49 (8): 622-5.
Goldberg SR1, Godder K, Lanning DA. Successful treatment of a bowel perforation after chemotherapy for Burkitt lymphoma. J Pediatr Surg. 2007 Mar; 42 (3): E1-3.
Samir Ranjan Nayak, 1,* Ganni Bhaskara Rao, 1 Subramanya Sarma Yerraguntla et al, Jejunal Perforation: A Rare Presentation of Burkitt's Lymphoma—Successful Management. Case Rep Oncol Med. 2014; 2014: 538359.
Natalie L, Yanchar, JuanBass. Poor outcome of gastrointestinal perforations associated with childhood abdominal non-Hodgkin's lymphoma. Journal of Pediatric Surgery,Volume 34, Issue 7, July 1999, Pages 1169-1174.