Pediatric Lymphoma in Jordan: A Retrospective Single-Center Study of Clinical Presentation, Treatment, and Outcomes.
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BACKGROUND: Pediatric lymphoma, encompassing Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), represents a significant cause of childhood cancer morbidity with limited data available from Middle Eastern settings. This study aims to characterize the clinical presentations, biomarker profiles, treatment patterns, and outcomes of pediatric HL and NHL at a tertiary care center in Jordan. METHODS: This retrospective study included children aged 0-16 years diagnosed with HL or NHL at Queen Rania Children's Hospital in Jordan from 2015 to 2024. Data were collected on demographics, clinical presentation, laboratory markers, treatment regimens, and outcomes. Categorical data were analyzed using chi-square or Fisher's exact tests, continuous variables using Mann-Whitney U tests, and Event-Free Survival (EFS) was assessed using Kaplan-Meier curves. RESULTS: A total of 49 patients' data were analyzed. The findings indicate a high rate of late-stage diagnosis among pediatric lymphoma patients in Jordan, with 38 (77.5%) presenting at advanced stages. Most NHL cases involved aggressive subtypes, including Burkitt and T-lymphoblastic lymphoma. Compared with HL patients, those with NHL exhibited significantly higher median C-reactive protein (CRP; 78.5 mg/L vs. 12.0 mg/L, P = 0.027) and lactate dehydrogenase (LDH; 553 U/L vs. 355 U/L, P = 0.012), indicating greater systemic inflammation and tumor burden in NHL. Among 40 (81.6%) treatment-evaluable patients, chemotherapy achieved a 20 (50%) complete remission rate. Mortality occurred exclusively among NHL patients 13 (26.5%), primarily those with advanced or extranodal disease. Relapse was observed in six (15%) of patients, with a median time to relapse of 37.5 months. CONCLUSIONS: Pediatric lymphoma in Jordan is most often diagnosed at an advanced stage, particularly NHL. Advanced NHL is associated with increased mortality. Early diagnosis, targeted therapy implementation, and incorporation of biomarkers such as LDH and CRP are urgently needed to improve risk assessment and patient outcomes.