Cairo et al identified a number of factors predicting treatment failure in a pediatric patient with a mature B-cell non-Hodgkin’s lymphoma (NHL). The authors are from multiple hospitals and universities in the United States and Europe.
Patient selection: pediatric patient with a mature B-cell lymphoma (includes Burkitt’s lymphoma, Burkitt’s leukemia, diffuse large B-cell lymphoma and primary mediastinal B-cell lymphoma)
Parameters from the multivariate analysis:
(1) ratio of serum LDH to upper limit of normal (ULN)
(2) primary site
(3) bone marrow (BM) and central nervous system (CNS) involvement
Parameter
Finding
Relative Failure Rate
serum LDH ratio
< 2 times
1
>= 2 times
2
primary site
mediastinum
4.5
abdomen
2.7
retroperitoneum
2.7
head and neck
1.2
peripheral lymph node
1.0
other
1.2
BM and CNS
CNS negative
1
CNS positive, BM negative
1.8
CNS positive, BM positive
4.9
cumulative product for relative failure rate =
= PRODUCT(relative rate for each parameter)
Interpretation:
• minimum cumulative product: 1
• maximum cumulative product: 44.1
• The higher the product the greater the risk for treatment failure.
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