A RETROSPECTIVE COHORT ANALYSIS OF CHILDREN AND ADOLESCENTS WITH
LYMPHOBLASTIC LYMPHOMA IN LATIN AMERICA.
Magdalena Schelotto 1, Claudia Garrido2, Jaqueline Montoya 3, Bruno Cuturi1, Ana Rosa Braz 4, Flavio Luisi5, Mario Alberto Ornelas Sanchez 6,
Wendy Gomez 7, Pascale Gassant 8,
Kenia Miller 9, Armando Peña 10,
Godwin Job 11 , Hilmarie Muniz-Talavera11, Meenakshi Devidas 11, Victor M.
Santana 11, Sima Jeha 11, Paola
Friedrich 11, Monica Metzger 11,
Guillermo Chantada 1, 12.
1- Hospital Pereira Rossell. Fundación Pérez Scremini. Montevideo,
Uruguay
2- Unidad Nacional de Oncología Pediátrica (UNOP).Guatemala, Guatemala
3- Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú.
4- Hospital de Câncer Infantojuvenil de Barretos. São Paulo, Brasil
5- GRAACC/Instituto de Oncología Pediátrica/UNIFESP. São Paulo, Brasil
6- Hospital general de Tijuana. Tijuana, México.
7- Hospital infantil Robert Reid Cabral. Republica Dominicana.
8- Hospital Sant Damien. Haiti
9- Hospital del Niño Jose Renan Esquivel. Panamá
10- Hospital Escuela.Tegucigalpa, Honduras.
11- St. Jude Children’s Research Hospital. Memphis, United States of
America.
12- Hospital Sant Joan de Déu, Barcelona, España.
Correspondence author: Magdalena Schelotto. Fundacion Perez Scremini.
Hospital Pereira Rossell. Bulevar Artigas 1556. CP 11600 Montevideo
Uruguay. Email:
mgschelotto@gmail.com. +598
99281009
Running title: Lymphoblastic lymphoma in Latin America
Keywords: Lymphoblastic Lymphoma, non Hodgkin Lymphoma, children and
adolescents, Latin America, St. Jude Global Alliance.
Word count: 2229
Abstract word count: 247
Number of Tables: 3
Number of Figures: 6
ABSTRACT
BACKGROUND AND AIMS: There is scarce information about pediatric
lymphoblastic lymphoma (LLy) in low and middle-income countries. We
describe the clinical characteristics, treatment and outcome of a cohort
of children and adolescents with LLy in Latin America (LA).
METHODS: Retrospective study analyzing pediatric patients with LLy in 10
institutions of the St. Jude Global Alliance from nine LA countries
between 2007 and 2017.
RESULTS: One-hundred and twenty-six patients were included. Sixty
(47.6%) had T-LLy, 49 (38.9%) B-LLy and in 17 (13.5%) the
immunophenotype was unknown. Ninety-seven (77%) presented with stage
III/IV disease, and 42 (33.3%) in critical conditions. In 30 cases
(23.8%), the results of pathology diagnosis exceeded 15 days from
biopsy, and 23 patients (18%) required a review at another
institution. The EFS and OS at 5 years were 73% (SE 0.047) and 78%
(SE 0.0435), respectively. Five-year abandonment-sensitive EFS and OS
were 65% (SE 0.0477) and 70% (SE 0.0459), respectively. Events
included relapse/progression (n=22), refractory disease (n =1)
abandonment (n=11), induction death (n=4), death in complete remission
(n=4), and second malignancies (n=1).
CONCLUSIONS: A balanced proportion of LLy-T and B phenotypes was
observed. Diagnosis was a challenge. Most of the patients presented with
high-risk disease, and many in critical conditions. Toxic deaths and
abandonment represented nearly half of the events. Improvements in
diagnosis, supportive measures and follow up are imperative to improve
the outcomes of pediatric LLy in Latin America.
Abbreviations