674 - Treatment Outcomes in Pediatric Non-Hodgkin Lymphoma: A 13-Year Review from the National Children’s Hospital of Costa Rica

Publication Number: 3652.674

Kelly N. Delgado, University of Illinois College of Medicine, Morton, IL, United States; Pedro A. de Alarcon, University of Illinois College of Medicine, Peoria, IL, United States; Yessika Gamboa, National Children's Hospotal, Palmares, Alajuela, Costa Rica; Maria Thomas, University of Illinois College of Medicine Peoria, Peoria, IL, United States

Background: Pediatric non-Hodgkin lymphoma (nHL) is primarily characterized by five oncological diseases: Burkitt’s lymphoma, lymphoblastic lymphoma, anaplastic large cell lymphoma, diffuse large B-cell lymphoma, and primary mediastinal B-cell lymphoma. Low- and middle-income countries (LMIC) are estimated to represent 90% of all diagnosed worldwide cases of pediatric nHL however, not many data registries exist in these regions making it difficult to examine cancer incidence and mortality. Survival disparities are vast in nHL, high-income countries (HIC) survival rates exceed 90% while LMICs trail behind with survival rates as low as 20-50%. Costa Rica is recognized as a middle-income-country due its heterogeneous population, universal health system and high rates of citizens living in poverty, one out of every five citizens.

Objective: The objective of this study was to identify the event free survival (EFS) and overall survival (OS) for the 13-year cohort in Costa Rica. EFS is the percentage of patients who survived and did not undergo an event such as death, progression, relapse, or abandonment while OS is the percentage of patients who survived.

Design/Methods: Preliminary data underwent an initial data cleaning process via excel. Kaplan-Meier estimates were calculated to evaluate a preliminary EFS and OS for the cohort.

Results: 85 patients were eligible for evaluation. The mean age at diagnosis was 7.5 years old (y.o), age at diagnosis range was 1.3-14.5 y.o and the male-to-female ratio was 3.45:1. The most prevalent diagnosis was Burkitt’s lymphoma (70.5%). 66 patients are alive, 18 dead, and 1 lost to follow since data closure in July 2025. 61.1% of deaths occurred within one year of diagnosis. The overall 5-year EFS and OS were 83.5% and 84.7% and 10-year EFS and OS were 80.6% and 81.7%.

Conclusion(s): While survival rates are continuing to increase, more can be done to improve treatment outcomes in LMICs. The majority of deaths in the cohort were within one year of diagnosis pointing to treatment toxicities and rapid progression of disease as issues that plagued the cohort. Additionally 7 patients in the cohort had underlying immunodeficiencies. Further research is needed to examine effective treatment guidelines and toxicity management for the diverse patient populations in LMICs.