Update on non-Hodgkin lymphoma in children

Uzunova, Lena; Burke, Amos

doi:10.1016/j.paed.2015.10.001

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…It should be noted that the list of abdominal tumours described below (and see table 2) is not exhaustive but provides some information on more commonly encountered malignancies (figure 1). [1][2][3][4][5][6][7][8][9][10][11] initiAl investigAtions blood and urine tests Initial laboratory investigations typically include a full blood count, urea and creatinine, lactate dehydrogenase (LDH; a general marker of cell turnover and/or tumour bulk), bone profile, uric acid, liver function tests, clotting and urinalysis. Hypercalcaemia may occur with congenital mesoblastic nephroma, other rare abdominal tumours and as part of a paraneoplastic phenomenon (a collection of symptoms occurring remotely from the tumour and caused by circulating substances produced either by the tumour or by the immune system in response to the tumour).…”

Section: Aims Of History and Examinationmentioning

confidence: 99%

Fifteen-minute consultation: A general paediatrician’s guide to oncological abdominal masses

Uzunova

Bailie

Murray

2019

Arch Dis Child Educ Pract Ed

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The identification of an abdominal mass in a child, either coincidental or symptomatic, may be due to a tumour. An abdominal tumour may present with life-threatening symptoms, requiring prompt assessment and management. Although the discovery of such a finding usually warrants inpatient transfer or outpatient referral to the tertiary oncology centre, the initial evaluation, management and communication with the family by the general paediatrician is crucial. A thorough history and examination, which includes an organised, structured approach to abdominal masses, is paramount. The anatomical location of the mass, age of the patient and the presence of any associated symptoms or signs must be considered together in order to formulate a list of potential differential diagnoses and guide the next appropriate investigations. This article aims to guide general paediatricians through the assessment and initial management of a child presenting with an abdominal mass suspected to be a tumour.

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Section: Aims Of History and Examinationmentioning

confidence: 99%

Fifteen-minute consultation: A general paediatrician’s guide to oncological abdominal masses

Uzunova

Bailie

Murray

2019

Arch Dis Child Educ Pract Ed

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“…Non‐Hodgkin lymphoma (NHL) is a heterogenous group of malignancies that typically present as high‐grade extranodal disease, are managed with chemotherapy, and have excellent survival outcomes 1 . The WHO classification currently distinguishes over 70 different types of B‐cell NHLs, but Burkitt lymphoma (BL) and diffuse large B‐cell lymphoma (DLBCL) account for the vast majority of paediatric cases.…”

Section: Introductionmentioning

confidence: 99%

Challenging our understanding of B‐cell lymphomagenesis and risk: Paediatric high‐grade B‐cell lymphoma, not otherwise specified with a DDX3X::MLLT10 fusion and an IGH deletion

Hare,

Trotman,

Tarpey

et al. 2023

Pediatric Blood & Cancer

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We report a unique case of high‐grade B‐cell lymphoma, not otherwise specified in a 5‐year‐old child. Whole‐genome sequencing revealed a DDX3X::MLLT10 fusion, usually seen in T‐cell acute lymphoblastic leukaemia (ALL). This suggests the novel idea that MLLT10 fusions are capable of driving B‐cell malignancies. An IGH deletion usually only seen in adults was also found. These unique genetic findings provide novel insights into B‐cell lymphomagenesis. The child remains in remission 7 year post chemotherapy, which demonstrates that novel complex molecular findings do not always denote high‐risk disease.

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“…3 DLBCL occurs primarily in adults or older patients; however, it could also occur in children. 2,4 For decades, chemotherapy alone including cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) has been the standard treatment for DLBCL patients, which provided favorable results regarding achievable partial or complete remission, as well as survival rates. 5 However, treatment and management of DLBCL patients signi cantly improved since the discovery of the targeted cancer drug that is rituximab (Rituxan, Mabthera), which is an anti-CD20 chimeric monoclonal antibody that targets normal and malignant B cells; this has demonstrated substantial clinical results when in combination with CHOP regimen.…”

Section: Introductionmentioning

confidence: 99%

Adding Rituximab to Chemotherapy for Diffuse Large B-Cell Lymphoma Patients in Indonesia: A Cost Utility and Budget Impact Analysis

Putri

Setiawan

Saldi

et al. 2022

Preprint

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Background This study aims to estimate the cost-effectiveness and budget impact of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) compared to CHOP for the treatment of patients with diffuse large B-cell lymphoma (DLBCL) in Indonesia. Methods We conducted a cost utility analysis using Markov model over a lifetime horizon, from a societal perspective. Clinical evidence was derived from published clinical trials. Direct medical costs were gathered from hospital data. Direct non-medical costs, indirect costs, and utility data were primarily gathered by interviewing the patients. We applied 3% discount rate for both costs and effect. All monetary data are converted into USD (1 USD = IDR 14,000, 2019). Probabilistic sensitivity analysis was performed. In addition, from a payer perspective, budget impact analysis was estimated using price reduction scenarios. Results The incremental cost-effectiveness ratio (ICER) of R-CHOP was USD 4,674/LYG and 9,280/QALY. If we refer to the threshold three times the GDP per capita (USD 11,538), R-CHOP could thus be determined as a cost-effective therapy. Its significant health benefit has contributed to the considerable ICER result. Although the R-CHOP has been considered a cost-effective intervention, the financial consequence of R-CHOP if remain in benefit package under National Health Insurance (NHI) system in Indonesia is considerably substantial, approximately USD 66 million with 75% price reduction scenario. Conclusions As a favorable treatment for DLBCL, R-CHOP ensures value for money in Indonesia. Budget impact analysis provides results which can be used as further consideration for decision-makers in matters related to benefit packages.

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Update on non-Hodgkin lymphoma in children

Cited by 6 publications

References 5 publications

Fifteen-minute consultation: A general paediatrician’s guide to oncological abdominal masses

Fifteen-minute consultation: A general paediatrician’s guide to oncological abdominal masses

Challenging our understanding of B‐cell lymphomagenesis and risk: Paediatric high‐grade B‐cell lymphoma, not otherwise specified with a DDX3X::MLLT10 fusion and an IGH deletion

Adding Rituximab to Chemotherapy for Diffuse Large B-Cell Lymphoma Patients in Indonesia: A Cost Utility and Budget Impact Analysis

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