| ObjectiveThis study retrospectively and comprehensively analyzed the clinical characteristics,treatment methods and prognosis of 52 cases of children's mediastinal lymphoma admitted to children's hospital of the first affiliated hospital of zhengzhou university in the past five years,aiming to improve pediatricians' understanding of this disease,beware of misdiagnosis and delay,and achieve early diagnosis and early intervention.MethodsWe observed 52 cases of mediastinal lymphoma in our hospital during the period from June 2014 to December 2018,and collected information about:mediastinal lymphoma clinical characteristics,laboratory examinations,treatmentand survival.ResultsFrom January 2014 to December 2018 52 children with mediastinal lymphoma were admitted to the children's hospital of the first affiliated hospital of zhengzhou university,including 36 males(69%)and 16 females(31%).The age of onset fluctuated from 1 to 15 years old,with the median age of 8years old.There were 48 cases of non-hodgkin's lymphoma(92%),including 29 cases of T lymphoma(55.8%),11 cases of anaplastic lymphoma(21.2%),7 cases of Burkitt lymphoma(13.5%),1 case of diffuse large B cell lymphoma(1.9%),and 4 cases of Hodgkin's lymphoma(7.7%),Mixed cell type classic Hodgkin's lymphoma in 2 cases(3.8%),nodular sclerosing type classic Hodgkin's lymphoma in 2 cases(3.8%);Among 52 children with mediastinal lymphoma,T lymphocyte lymphoma had the largest number of cases,followed by anaplastic lymphoma.Diffuse large B cell lymphocytes are the least common.Lactate dehydrogenase(LDH)level was used as the tumor load indicator,and increased in 40 cases(77%)of the 52 cases,among which t-lbl was the most common,accounting for about 24 cases,accounting for 60% of the overall increase.Elevated alkaline phosphatase(ALP)level in 3 cases(5.5%);As one of the independent risk factors related to prognosis,systemic symptoms were found in 37 cases(71.2%)of 52 cases of lymphoma in this study,including fever in 23 cases(43%,23/52),cough in 30 cases(56%,30/52),abdominal pain and abdominal distension in 5 cases(9%,5/52),fatigue in 2 cases(3%,2/52),chest pain and chest tightness in 2 cases(3%,2/52).15 cases without systemic symptoms(28.8%)There were various types of mediastinal ML.4 cases of mediastinal HL were all treated with ABV chemotherapy.In the NHL,8 cases of mature B-cell lymphoma were treated with BFM-95 chemotherapy,11 cases of anaplastic lymphoma were treated with BCH-2010 chemotherapy,and 29 cases of lymphoblastic lymphoma were treated with modified BFM-95 chemotherapy and precursor lymphoblastic lymphoma chemotherapy.Except for 1 patient who was not treated after diagnosis,and 4 patients who were lost to follow-up during treatment.The remaining 47 cases were all received formal treatment.Currently,35 cases(74.5%)survived,12 cases(25.5%)died,and 47 cases had 1-year overall survival rate(OS)of 88%,3-year overall survival rate of 70.5%,and 5-year overall survival rate of 56%.Conclusions1.Mediastinal lymphoma progresses rapidly and the prognosis is relatively poor.The 5-year survival rate is about 56%.2.Mediastinal lymphoma can occur in both men and women,and more boys than girls.Among them,the most common is lymphoblastic lymphoma,diffuse large B cell lymphoma rarely involve the mediastinum.3.LDH value can be a tumor load index,and has a certain relationship with prognosis.4.Non-hodgkin's lymphoma is the most common type of mediastinal lymphoma,while Hodgkin's lymphoma is rare,LDH 2-fold normality was considered to be an independent risk factor for lymphoma prognosis. |
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