Predictors for reactive thymic hyperplasia and its prognostic value in children and adolescents with lymphoma

Ying Ying Hu, Li Tian, Xu Zhang, Zi Zheng Xiao, Wei Dong Zhang, Xiao Ping Lin, Ya Rui Zhang, Wen Long, Wei Fan

Research output: Contribution to journalArticle

Abstract

Background: Reactive thymic hyperplasia (RTH) is seen in children and adolescents receiving chemotherapy for various malignancies. However, it is not clear why this occurs only in some patients. The aim of this study was to identify the predictors for RTH in children and adolescents receiving chemotherapy for lymphoma and to determine the effect of RTH on prognosis. Methods: We reviewed the medical records of 126 lymphoma patients (October 2007–October 2012). The patients were divided into two groups according to different criteria, i.e., age at initial diagnosis (2–12 years vs. 13–18 years); presence of thymic infiltration at baseline (yes vs. no); and receipt of mediastinal radiotherapy (yes vs. no). The Kaplan-Meier method and multivariate Cox regression model analysis were used to analyze predictors for RTH. Further, patients were divided into two groups according to the occurrence of RTH during follow-up, and Kaplan-Meier survival analysis was used to analyze the prognostic value of RTH. Results: The 2–12-year-old group had a shorter duration from the end of therapy to RTH than the 13–18-year-old group (median: 3 months vs. 16 months) and a higher rate of RTH (97.1% vs. 60.3%, P < 0.001). The lymphoma thymic non-infiltration group had a shorter duration from the end of therapy to RTH than the lymphoma infiltration group (median: 4 months vs. 22 months), and a higher rate of RTH (88.2% vs. 57.6%, P < 0.001). The non-mediastinal radiotherapy group had higher rate of RTH than the mediastinal radiotherapy group (84.7% vs. 12.5%, P < 0.001). Low age, absence of thymic infiltration by lymphoma at baseline, and absence of mediastinal radiation were predictors for RTH by multivariate Cox regression analysis (P < 0.05). The RTH group had a lower recurrence rate than the non-RTH group (13.9% vs. 40%), and a longer duration from the end of therapy to recurrence (median: 10 months vs. 5 months, P < 0.001). Conclusions: Younger age, absence of thymic infiltration by lymphoma at baseline and absence of mediastinal radiotherapy are predictors for RTH in children and adolescents. RTH may be a positive prognostic factor.

Original languageEnglish (US)
Pages (from-to)108-113
Number of pages6
JournalEuropean Journal of Radiology
Volume109
DOIs
StatePublished - Dec 1 2018

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Thymus Hyperplasia
Lymphoma
Radiotherapy
Regression Analysis
Recurrence
Drug Therapy

Keywords

  • Adolescents
  • Children
  • Lymphoma
  • Prognosis
  • Thymic hyperplasia

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Predictors for reactive thymic hyperplasia and its prognostic value in children and adolescents with lymphoma. / Hu, Ying Ying; Tian, Li; Zhang, Xu; Xiao, Zi Zheng; Zhang, Wei Dong; Lin, Xiao Ping; Zhang, Ya Rui; Long, Wen; Fan, Wei.

In: European Journal of Radiology, Vol. 109, 01.12.2018, p. 108-113.

Research output: Contribution to journalArticle

Hu, Ying Ying ; Tian, Li ; Zhang, Xu ; Xiao, Zi Zheng ; Zhang, Wei Dong ; Lin, Xiao Ping ; Zhang, Ya Rui ; Long, Wen ; Fan, Wei. / Predictors for reactive thymic hyperplasia and its prognostic value in children and adolescents with lymphoma. In: European Journal of Radiology. 2018 ; Vol. 109. pp. 108-113.
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abstract = "Background: Reactive thymic hyperplasia (RTH) is seen in children and adolescents receiving chemotherapy for various malignancies. However, it is not clear why this occurs only in some patients. The aim of this study was to identify the predictors for RTH in children and adolescents receiving chemotherapy for lymphoma and to determine the effect of RTH on prognosis. Methods: We reviewed the medical records of 126 lymphoma patients (October 2007–October 2012). The patients were divided into two groups according to different criteria, i.e., age at initial diagnosis (2–12 years vs. 13–18 years); presence of thymic infiltration at baseline (yes vs. no); and receipt of mediastinal radiotherapy (yes vs. no). The Kaplan-Meier method and multivariate Cox regression model analysis were used to analyze predictors for RTH. Further, patients were divided into two groups according to the occurrence of RTH during follow-up, and Kaplan-Meier survival analysis was used to analyze the prognostic value of RTH. Results: The 2–12-year-old group had a shorter duration from the end of therapy to RTH than the 13–18-year-old group (median: 3 months vs. 16 months) and a higher rate of RTH (97.1{\%} vs. 60.3{\%}, P < 0.001). The lymphoma thymic non-infiltration group had a shorter duration from the end of therapy to RTH than the lymphoma infiltration group (median: 4 months vs. 22 months), and a higher rate of RTH (88.2{\%} vs. 57.6{\%}, P < 0.001). The non-mediastinal radiotherapy group had higher rate of RTH than the mediastinal radiotherapy group (84.7{\%} vs. 12.5{\%}, P < 0.001). Low age, absence of thymic infiltration by lymphoma at baseline, and absence of mediastinal radiation were predictors for RTH by multivariate Cox regression analysis (P < 0.05). The RTH group had a lower recurrence rate than the non-RTH group (13.9{\%} vs. 40{\%}), and a longer duration from the end of therapy to recurrence (median: 10 months vs. 5 months, P < 0.001). Conclusions: Younger age, absence of thymic infiltration by lymphoma at baseline and absence of mediastinal radiotherapy are predictors for RTH in children and adolescents. RTH may be a positive prognostic factor.",
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author = "Hu, {Ying Ying} and Li Tian and Xu Zhang and Xiao, {Zi Zheng} and Zhang, {Wei Dong} and Lin, {Xiao Ping} and Zhang, {Ya Rui} and Wen Long and Wei Fan",
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T1 - Predictors for reactive thymic hyperplasia and its prognostic value in children and adolescents with lymphoma

AU - Hu, Ying Ying

AU - Tian, Li

AU - Zhang, Xu

AU - Xiao, Zi Zheng

AU - Zhang, Wei Dong

AU - Lin, Xiao Ping

AU - Zhang, Ya Rui

AU - Long, Wen

AU - Fan, Wei

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Reactive thymic hyperplasia (RTH) is seen in children and adolescents receiving chemotherapy for various malignancies. However, it is not clear why this occurs only in some patients. The aim of this study was to identify the predictors for RTH in children and adolescents receiving chemotherapy for lymphoma and to determine the effect of RTH on prognosis. Methods: We reviewed the medical records of 126 lymphoma patients (October 2007–October 2012). The patients were divided into two groups according to different criteria, i.e., age at initial diagnosis (2–12 years vs. 13–18 years); presence of thymic infiltration at baseline (yes vs. no); and receipt of mediastinal radiotherapy (yes vs. no). The Kaplan-Meier method and multivariate Cox regression model analysis were used to analyze predictors for RTH. Further, patients were divided into two groups according to the occurrence of RTH during follow-up, and Kaplan-Meier survival analysis was used to analyze the prognostic value of RTH. Results: The 2–12-year-old group had a shorter duration from the end of therapy to RTH than the 13–18-year-old group (median: 3 months vs. 16 months) and a higher rate of RTH (97.1% vs. 60.3%, P < 0.001). The lymphoma thymic non-infiltration group had a shorter duration from the end of therapy to RTH than the lymphoma infiltration group (median: 4 months vs. 22 months), and a higher rate of RTH (88.2% vs. 57.6%, P < 0.001). The non-mediastinal radiotherapy group had higher rate of RTH than the mediastinal radiotherapy group (84.7% vs. 12.5%, P < 0.001). Low age, absence of thymic infiltration by lymphoma at baseline, and absence of mediastinal radiation were predictors for RTH by multivariate Cox regression analysis (P < 0.05). The RTH group had a lower recurrence rate than the non-RTH group (13.9% vs. 40%), and a longer duration from the end of therapy to recurrence (median: 10 months vs. 5 months, P < 0.001). Conclusions: Younger age, absence of thymic infiltration by lymphoma at baseline and absence of mediastinal radiotherapy are predictors for RTH in children and adolescents. RTH may be a positive prognostic factor.

AB - Background: Reactive thymic hyperplasia (RTH) is seen in children and adolescents receiving chemotherapy for various malignancies. However, it is not clear why this occurs only in some patients. The aim of this study was to identify the predictors for RTH in children and adolescents receiving chemotherapy for lymphoma and to determine the effect of RTH on prognosis. Methods: We reviewed the medical records of 126 lymphoma patients (October 2007–October 2012). The patients were divided into two groups according to different criteria, i.e., age at initial diagnosis (2–12 years vs. 13–18 years); presence of thymic infiltration at baseline (yes vs. no); and receipt of mediastinal radiotherapy (yes vs. no). The Kaplan-Meier method and multivariate Cox regression model analysis were used to analyze predictors for RTH. Further, patients were divided into two groups according to the occurrence of RTH during follow-up, and Kaplan-Meier survival analysis was used to analyze the prognostic value of RTH. Results: The 2–12-year-old group had a shorter duration from the end of therapy to RTH than the 13–18-year-old group (median: 3 months vs. 16 months) and a higher rate of RTH (97.1% vs. 60.3%, P < 0.001). The lymphoma thymic non-infiltration group had a shorter duration from the end of therapy to RTH than the lymphoma infiltration group (median: 4 months vs. 22 months), and a higher rate of RTH (88.2% vs. 57.6%, P < 0.001). The non-mediastinal radiotherapy group had higher rate of RTH than the mediastinal radiotherapy group (84.7% vs. 12.5%, P < 0.001). Low age, absence of thymic infiltration by lymphoma at baseline, and absence of mediastinal radiation were predictors for RTH by multivariate Cox regression analysis (P < 0.05). The RTH group had a lower recurrence rate than the non-RTH group (13.9% vs. 40%), and a longer duration from the end of therapy to recurrence (median: 10 months vs. 5 months, P < 0.001). Conclusions: Younger age, absence of thymic infiltration by lymphoma at baseline and absence of mediastinal radiotherapy are predictors for RTH in children and adolescents. RTH may be a positive prognostic factor.

KW - Adolescents

KW - Children

KW - Lymphoma

KW - Prognosis

KW - Thymic hyperplasia

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