Certain Risk Factors May Decrease Overall Survival in Pediatric B-NHL

Various risk factors associated with shortened overall survival (OS) among children and adolescents with B-cell non-Hodgkin lymphoma (B-NHL) have been identified, according to a study published in the British Journal of Haematology.¹

Previous analyses of the international French-American-British/mature lymphoma B 96 (FAB/LMB 96) study resulted in positive outcomes and found risk factors significantly associated with relapsed/refractory disease, but factors that affect OS required further study.

In the FAB/LMB 96 study, researchers enrolled 1111 children and adolescents with newly diagnosed mature B-NHL; patients were assigned to 3 groups and received different intensive multidrug chemotherapies. For this retrospective analysis, researchers evaluated the outcomes of 104 patients (9.4%) who either had refractory (28; 27%) or relapsed (76; 73%) disease after first complete remission.

The median follow-up after treatment failure was 4.4 years. The estimated 1-year OS was 31.5% (95% CI, 23.3-41.0) and 2-year OS was 22.3% (95% CI, 15.3-31.4).

A Cox multivariate model analysis showed that lactate dehydrogenase 2 or more times the upper normal limit at diagnosis (P = .0006), time to failure greater than or equal to 6 months (P = .038), and failure in bone marrow (P = .0001), were independently and significantly associated with decreased OS. 

The authors concluded that “new therapeutic strategies are required to significantly reduce refractory disease and disease relapse in patients with newly diagnosed mature B-NHL and, more importantly, there is a critical need to develop novel retrieval approaches in patients with chemotherapy-resistant disease.”

Reference

1. Cairo M, Auperin A, Perkins SL, Pinkerton R, Harrison L, Goldman S, Patte C. Overall survival of children and adolescents with mature B cell non-Hodgkin lymphoma who had refractory or relapsed disease during or after treatment with FAB/LMB 96: A report from the FAB/LMB 96 study group [published online July 9, 2018]. Br J Haematol. doi: 10.1111/bjh.15491