Clinical characteristics and treatment evaluation of diffuse large B-cell lymphoma in Chinese children and adolescents: a multicenter clinical study of China-Net childhood lymphoma group B-NHL-2017.
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BACKGROUND: China-Net Childhood Lymphoma (CNCL) group B-NHL-2017 study is a prospective multi-center study in China, with the purpose of standardizing the diagnosis and treatment of childhood lymphoma, and improving the prognosis. METHODS: From May 2017 to June 2023, 20 centers participated in the diffuse large B-cell lymphoma (DLBCL) study. The clinical data were analyzed to summarize the clinical characteristics, treatment response and outcome. The primary endpoint was 5-year event-free survival (EFS). The trial is registered with the Chinese Clinical Trial Registry (ChiCTR1800020067). RESULTS: A total of 138 children and adolescents were enrolled, including 101 males and 37 females. The median age of disease diagnosis was 9.0 years (range: 2.3-15.5 years). The range of follow-up time was 17 d-6.0 years. A total of 12 events occurred in this study, including 7 deaths. of which 4 patients died of disease and chemotherapy comorbidities (severe infection, septic shock, etc.), 1 died of disease progression (enlargement of the primary tumor and tumor metastasis), 1 died of recurrence, and 1 died of severe pneumonia in the third year after completing all chemotherapy courses. Recurrence occurred in 6 (4.3%) patients at 14.9 months (range: 4.4-32.6 months) after initial treatment. The 5-year overall survival (OS) was 90.7 ± 5.0% and the 5-year EFS was 85.5 ± 5.4%. Based on Cox regression analysis, no Rituximab during treatment is an independent risk factor for mortality in patients with DLBCL. CONCLUSION: The efficacy of CNCL-B-NHL-2017 protocol in the treatment of DLBCL in children and adolescents is close to results of international studies.