
儿童霍奇金淋巴瘤的临床特征及生存分析:一项多中心临床研究
林蓥, 潘丽丽, 乐少华, 李健, 郭碧赟, 朱玉, 翁开枝, 罗锦泓, 孙高源, 郑湧智
中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (6) : 668-674.
儿童霍奇金淋巴瘤的临床特征及生存分析:一项多中心临床研究
Clinical characteristics and survival analysis of pediatric Hodgkin lymphoma: a multicenter study
目的 探讨儿童霍奇金淋巴瘤(Hodgkin lymphoma, HL)的临床病理特征及预后因素。 方法 回顾性分析2011年1月—2023年12月期间福建医科大学附属协和医院、福建医科大学附属漳州市医院、厦门大学附属第一医院及福建省儿童医院等4家医院初诊HL患儿临床资料。按HL分期及治疗前危险因素分为低危组(R1组)、中危组(R2组)和高危组(R3组)。按治疗方案不同,分为ABVD方案和中国儿童HL-2013方案化疗组。评估其早期治疗反应及远期疗效,并采用Cox比例风险回归模型分析预后因素。 结果 总体化疗2疗程及4疗程后完全反应(complete response, CR)率分别为42%、68%。与ABVD方案组比较,接受HL-2013方案的患儿中,R1组2疗程及4疗程CR率显著增高(P<0.05),但R2/R3组CR率差异无统计学意义(P>0.05)。患儿5年无事件生存(event-free survival, EFS)率、总生存率及无治疗失败生存率分别为83%±4%、97%±2%及88%±4%。Cox分析显示,初诊伴有巨大瘤灶、化疗4疗程后未达CR是较低EFS率的独立危险因素(P<0.05)。 结论 儿童HL总体预后良好。初诊伴有巨大瘤灶、化疗4疗程后未达CR提示预后不良。
Objective To investigate the clinicopathological characteristics and prognostic factors of pediatric Hodgkin lymphoma (HL). Methods A retrospective analysis was conducted on the clinical data of children with newly diagnosed HL from January 2011 to December 2023 at four hospitals: Fujian Medical University Union Hospital, Fujian Medical University Zhangzhou Hospital, First Affiliated Hospital of Xiamen University, and Fujian Children's Hospital. Patients were categorized into low-risk (R1), intermediate-risk (R2), and high-risk (R3) groups based on HL staging and pre-treatment risk factors. The patients received ABVD regimen or Chinese Pediatric HL-2013 regimen chemotherapy. Early treatment response and long-term efficacy were assessed, and prognostic factors were analyzed using the Cox proportional hazards regression model. Results The overall complete response (CR) rates after 2 and 4 cycles of chemotherapy were 42% and 68%, respectively. Compared with the ABVD regimen group, patients treated with the HL-2013 regimen in the R1 group showed significantly higher CR rates after both 2 and 4 cycles (P<0.05). However, no statistically significant differences in CR rates were observed between the two regimens in the R2 and R3 groups (P>0.05). The 5-year event-free survival (EFS) rate, overall survival rate, and freedom from treatment failure rate were 83%±4%, 97%±2%, and 88%±4%, respectively. Cox analysis indicated that the presence of a large tumor mass at diagnosis and failure to achieve CR after 4 cycles of chemotherapy were independent risk factors for lower EFS rates (P<0.05). Conclusions Pediatric HL generally has a favorable prognosis. The presence of a large tumor mass at diagnosis and failure to achieve CR after 4 cycles of chemotherapy indicate poor prognosis.
Hodgkin lymphoma / Chemotherapy / Prognostic analysis / Child
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林蓥负责研究设计、文章撰写;潘丽丽、乐少华、李健、郭碧赟、朱玉、翁开枝、罗锦泓、孙高源负责病例资料收集和数据整理;郑湧智负责研究设计、数据统计分析、论文修改。