Bowel Obstruction and Perforation in Pediatric Intestinal Mature B Cell Lymphoma: Incidence, Clinical Features, and Outcome in CCHE

Abstract

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 [1]. 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.