Linfoma no Hodgkin en niños. Experiencia y actualización de una institución

Pediatric non Hodgkin lymphoma is the third cause of pediatric cancer. We present the experience in our institution between January 2000 and May 2013, with 67 patients who completed 1LNHP 2000 GATLA Trial. The mean follow up was 69 m (r: 0.33 m-160.4 m), using anatomopathological WHO classification and St Jude (Murphy) estadification criteria. Our patients mean age was 139 m (r: 5 m-211 m), with male predominance (59.7%). We evaluated the level of LDH at diagnosis with a mean of 1497 IU/L. The distribution according to histology was: BL 47.8%, DLCBL 20.9 %, LL 13.4 %, ALCL 11.9 % and others 4.5 %. The distribution according to Murphy’s stadification was: I (3.1%), II (24.6%), III (60%), IV (10.8%) and IVZ (1.5%). The risk estadification as follows: 1 (1.5%), 2 (26.2%), 3 (69.2%), 4 (3.1%). In DLCBL we observed a predominance of risks 1-2 (p: 0.015) and stages I-II (p: 0.023). In LL the most prevalent risks were 3-4 (p: 0.0128) and stages III-IV (p: 0.05). The more frequent locations were: abdominal 27%, cervical 10.4%, BM: 10,4%, mediastinal 10.4%, bone 10.4%, skin 10,4%, lung 7,5%, CNS 4.5% and liver 3%. BL had a significant correlation with abdominal and cervical location (p: <0.01), DCBL with cervical location (p: 0.043), LL with mediastinal location (p: <0.01) and ALCL with lung location (p: <0.01). The global complete remission (CR) rate was: 91%. The event free survival (EFS) was 83 % at 12 months, 79% at 24 months and 77.9% at 36 months. Nine patients relapsed (14.8%), 3 early relapses and 6 late relapses. Overall survival rates were 89% at 12 months, 82% at 24 months and 79.1% at 36 months. EFS and OS were similar to the reported in the literature. Currently there are new criteria available for stadification and prognosis of NHL.