Demographics And Outome In Paediatric Non-hodgkin Lymphoma: Single Centre Experience At The Children Hospital Lahore, Pakistan

Faizan, Mahwish; Anwar, Saadia; Khan, Safia

doi:10.29271/jcpsp.2018.01.48

Cited by 10 publications

(9 citation statements)

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“…Burkitt’s lymphoma is the most common diagnosis in previous studies; our results confirm this finding. Most patients presented with an advanced stage which is similar to data available 2,12,15,16. On multivariate analysis, we found sepsis, tumor lysis syndrome and malnutrition as significant.…”

Section: Discussionsupporting

confidence: 86%

“…With modern intensive multi-agent chemotherapy protocols adopted after several consecutive international trials, a five years survival for B cell non-Hodgkin’s Lymphoma has reached up to 80 – 90 % in the developed world. However, in low-income countries such as Pakistan results are not so promising due to delay in seeking medical care, improper and delayed referral system, low socio-economic status and lack of awareness 2. Furthermore, factors such as malnutrition, and lack of supportive care lead to reduced tolerance to chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition, Sepsis and Tumor Lysis Syndrome Are Associated With Increased Rate of Acute Mortality in Mature B Cell Non-Hodgkin Lymphoma in Pediatric Population- Study From Tertiary Care Hospital in Pakistan

Mansoor¹,

Saeed²,

Wali³

et al. 2019

Mediterr J Hematol Infect Dis

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Background: Outcomes of pediatric mature B cell NHL in resource challenged countries are negatively affected by increased rate of early and toxic deaths. Aim of this study is to assess rate of acute mortality and define significant risk factors present in children with mature B Cell NHL. Methods: A retrospective analysis was done of patients with B cell NHL from January 2012 till December 2016. Risk factors studied for acute mortality were malnutrition, stage, prior surgery with open laparotomy, LDH levels, tumor lysis syndrome, sepsis and fungal infection Results: Total 233 patients were enrolled in the study. Eighty five (36.4%) were below 15th percentile. Treatment was started in 226 patients. Eighty eight percent children showed 20% response after COP pre-phase. Tumor lysis syndrome was developed in 20.6 % (n = 48) children and 42.9% (n = 100) patients had sepsis, 71/100 patients had culture proven sepsis. 19.7% (n = 46) patients developed fungal infection. There was 19.7% (n = 46) acute mortality. Most common cause of death was sepsis (n = 22, 47.8%) followed by acute renal failure secondary to tumor lysis syndrome. On multivariate analysis, three independent variables found significant for early death are malnutrition, sepsis and tumor lysis syndrome. Conclusion: Rate of acute mortality in B cell NHL is high in our set up and significant risk factors are tumor lysis syndrome, sepsis and malnourishment at time of presentation.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Malnutrition, Sepsis and Tumor Lysis Syndrome Are Associated With Increased Rate of Acute Mortality in Mature B Cell Non-Hodgkin Lymphoma in Pediatric Population- Study From Tertiary Care Hospital in Pakistan

Mansoor¹,

Saeed²,

Wali³

et al. 2019

Mediterr J Hematol Infect Dis

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“…In the abdomen, the disease can preferably involve mesenteric lymph nodes (more common in high income countries) and/or preferably involve intestinal wall in various segments (frequent presentation in low- and middle-income countries (LMICs)). Patients with abdominal primary may present initially to surgeons, either with an asymptomatic abdominal mass or acute abdomen [ 5 ].…”

Section: Special Considerations For Abdominal Burkitt Lymphomamentioning

confidence: 99%

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

Abib¹,

Chui²,

Cox³

et al. 2022

ecancer

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Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries.The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with pediatric surgical oncology worldwide. This organization allows experts in the field from around the globe to gather and address the surgical needs of children with cancer. IPSO has been invited to contribute surgical guidance as part of the World Health Organization Initiative for Childhood Cancer. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High-(HICs) and Low-and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. These have been further validated by experts with the aim of providing evidence-based information for surgeons who care for children with cancer.We hope that this initiative will benefit children worldwide in the best way possible.

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“…However, such studies do not account for the extreme delays in diagnosis that occur in some LIC, where the most severe cases are never diagnosed at all because they succumb to metabolic complications or comorbid illness before a cancer diagnosis can be made (Moleti et al , ; Gaytan‐Morales et al , ) (Figs and ). For example, in one study in Pakistan, children with NHL presented with stage 3 disease in 91% of cases and stage 4 disease in the remainder, stages that are associated with much higher morbidity, mortality, and costs of care (Faizan et al , ).…”

Section: Management Of Burkitt Lymphoma In Low‐ and Middle‐income Coumentioning

confidence: 99%

Optimizing outcomes for children with non‐Hodgkin lymphoma in low‐ and middle‐income countries by early correct diagnosis, reducing toxic death and preventing abandonment

2019

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In high-income countries, more than 90% of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low-and middle-income countries (LMIC), cure rates range from 20% to 70% because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.

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Demographics And Outome In Paediatric Non-hodgkin Lymphoma: Single Centre Experience At The Children Hospital Lahore, Pakistan

Cited by 10 publications

References 1 publication

Malnutrition, Sepsis and Tumor Lysis Syndrome Are Associated With Increased Rate of Acute Mortality in Mature B Cell Non-Hodgkin Lymphoma in Pediatric Population- Study From Tertiary Care Hospital in Pakistan

Malnutrition, Sepsis and Tumor Lysis Syndrome Are Associated With Increased Rate of Acute Mortality in Mature B Cell Non-Hodgkin Lymphoma in Pediatric Population- Study From Tertiary Care Hospital in Pakistan

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

Optimizing outcomes for children with non‐Hodgkin lymphoma in low‐ and middle‐income countries by early correct diagnosis, reducing toxic death and preventing abandonment

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