Clinical Features And Prognostic Factors Of 36 Children With Hodgkin’s Lymphoma

Objective: To collect 36 cases of Hodgkin lymphoma patients from January2000 to December 2015 in the fourth hospital of Hebei Medical University,and analyze their clinical characteristics and prognosis related factors,so as to provide theoretical basis for the diagnosis,improvement of treatment plan,layered and accurate treatment and prognosis prediction,so as to improve the survival and prognosis of children Hodgkin lymphoma.Methods: The clinical records of 36 children with Hodgkin lymphoma were obtained by consulting the medical records.The prognosis of these children was followed up for a long time by telephone follow-up,outpatient and ward follow-up.The age,sex,clinical stage,pathological classification,presence of large tumor foci and extranodal involvement,B symptom,LDH level,EB virus infection history,whether methylbianhydrazine and radiotherapy history were used in chemotherapy were analyzed by retrospective analysis.Spss26 statistical software was used to analyze the statistical analysis.Fisher exact probability method was used to compare the two methods.Kaplan Meier method drew survival curve,and then analyzed the single factor by log rank test.All P values were bilateral,P < 0.05 was statistically significant.Results:1.Among the 36 children with Hodgkin lymphoma,the average age of onset was 6.3 years,median age was 5 years old,26 male children(72.2%),10 female children(27.8%),male: female 2.6:1.The main symptoms were neck tumors in 30(83%),axillary tumors in 2(6%),abdominal tumors in 1(3%),submaxillary tumors in 1(3%),pain under scapular(3%)and whole blood cell reduction(3%)in 1 person.2.36 children with Hodgkin’s lymphoma were diagnosed as Hodgkin’s lymphoma by biopsy or surgical resection.According to who lymphoma classification revised in 2017,36 children can be divided into mixed cell type(27 cases),nodule sclerosing type in 5 cases(13.8%),nodular lymphocyte type in 4 cases(11.2%).The EFS of mixed cell type was 89.3% in 5 years,66.7% in 5 years of tuberous sclerosing type,100%in 5 years for nodular lymphocytic type.3.According to Ann Arbor staging criteria,there were 5 cases(13.9%)in stage Ⅱ,12 cases(33.3%)in stage Ⅲ and 19 cases(52.8%)in stage Ⅳ.The 5-year EFS was 100% in stage Ⅱ,100% in stage Ⅲ and81.9% in stage Ⅳ.4.Four Among 36 children,10(27.8%)had B symptoms,26(72.2%)without B symptoms,70% and 94.1% EFS in 5 years without B symptoms;5(13.9%)had giant tumor foci,31 cases(86.1%)without giant tumor foci,30% and 100% EFS in 5 years without massive tumor foci,21 cases(58.3%)with extranodal involvement,and no EFS in 5years 15 cases(41.7%)were involved outside the knot.5.Among 36 children,7(19.4%)were infected with EBV virus,29cases(80.6%)were not infected with EBV virus;7 cases(19.4%)were increased LDH,29 cases(80.6%)were not increased,and the EFS of patients with LDH level increased and not increased in 5 years were53.3% and 100% respectively.There were 21 cases(58.3%)using MBH and 15 cases(41.7%)not using MBH.The 5-year EFS of using MBH and not using MBH were90.9% and 82.5% respectively.There were 31 cases with indication of radiotherapy,6 cases(30.6%)performed and 25 cases(69.4%)not performed.6.36 children were followed up for a long time,including 19 cases(52.8%)of them were completely relieved,12 cases(33.3%)were partially relieved.1 case was recurred and survived,2 died after recurrence(5.6%),and 1 case died of complication.The 5-year event-free survival rate was 87.7%.7.Fisher exact probability method showed that there was no significant data difference in age,gender,first symptom,clinical stage,extranodal involvement,EBV infection,history of radiotherapy and use of MBH,but there was significant data difference in B symptom,pathological type,LDH level and giant tumor.Conclusions:1.There were no significant correlation factors with prognosis of children with Hodgkin’s lymphoma,including age,sex,first symptom,clinical stage,extranodal involvement,EBV virus infection,radiotherapy history and whether methylbenzylhydrazine.2.The factors related to prognosis of Hodgkin lymphoma children were B symptom,pathological classification,LDH level and giant tumor foci was used.3.The 5-year event-free survival rate of 36 children in this study was 87.7%.