[Clinical Efficacy and Prognostic Factors of Newly Diagnosed Children[JP] with Burkitt Lymphoma Treated by High-Dose and Short-Course Modified LMB Regimen ± Rituximab].

Objective: To investigate the clinical efficacy and prognostic factors of high-dose and short-course modified LMB regimen ± Rituximab in the treatment of newly diagnosed children with Burkitt lymphoma, soas to provide more reference for clinical diagnosis and treatment with follow-up.
Methods: 91 newly diagnosed children with Burkitt lymphoma treated in our hospital from January 2007 to August 2016 were chosen. High-dose and short-course modified LMB regimen were used to treat children at different risk levels- Rituximab were added in treatment of high-risk group. The clinical characteristics and efficacy of the treatment were analyzed, and the related prognostic factors were evaluated.
Results: The overall survival rate and event-free survival rate in 5-year with follow-up of 91 children were separately（89.27±2.69）%， （87.16±2.30）%; the event-free survival rate of patients in 5-year with follow-up in low-risk, moderate-risk and high-risk group were separately 100%，（94.51±2.97）%，（84.60±3.40）%. The event-free survival rate in 5-year with follow-up of high-risk group were significantly lower than that of moderate-risk group（P<0.05）. Univariate analysis showed that the combination of maxillofacial and central nervous system invasion, LDH >1000 U/L, proportion of bone marrow tumor cell >25%, organ involvement number >4, St. Jude stage for IV stage, early chemotherapy insensitivity and tumor lesion in mid-term evaluation were risk factor for poor prognosis in newly diagnosed children with Burkitt lymphoma（P<0.05）.Multivariate analysis showed that the combination of maxillofacial and central nervous system invasion, early chemotherapy insensitivity and tumor lesion in mid-term evaluation were the independent risk factor for poor prognosis of children with Burkitt lymphoma（P<0.05）. The EFS rate in 5-year with follow-up of high-risk children treated with chemotherapy+rituximab was significantly higher than that of chemotherapy alone（P<0.05）.
Conclusion: High-dose and short-course modified LMB regimen in the treatment of newly diagnosed children with Burkitt lymphoma shows satisfactory clinical efficacy. The children with central nervous system involvement, early chemotherapy insensitivity and tumor lesion in mid-term evaluation show the worse prognosis, while Rituximab added is more helpful to improve the long-term prognosis for high-risk children with Burkitt lymphoma.