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Name: Dr Nahla Ali Mobark
King Fahad Medical City KFMC Riyadh Saudi Arabia
Phone No: 00966539417319
Email: nmobark@kfmc.med.sa
Riyadh 11525, PO Box59046
Biography
Dr Nahla Mobark is pediatric oncologist in Pediatric Hematology & Oncology Department
in Cancer Center King Fahad Medical City KFMC, Riyadh Saudi Arabia which is huge
tertiary hospital in with around 1000 bed capacity
She had MBBS from KASER-ELAINI Medical College Cairo University, then pediatric
residency in Children hospital king Saud medical complex KSMC Ministry of Health
(MOH) of Saudi Arabia ,she had membership of Royal College Of Pediatric & Child
Health, UK MRCPCH, and then pediatric hematology oncology fellowship program with
training in bone marrow transplant
She had got a big experience in diagnosing &management of pediatric patients with
hematological malignancies and solid tumours also benign hematology cases i.e .SCA,
thalassemia etc.
Dr Nahla have been involved with teaching of undergraduate and postgraduate students
and nurses throughout her career
LAST RESERCH
1. Pediatric non-Hodgkin Lymphoma retrospective study on children with Non-Hodgkin
lymphoma treated in KFMC
2. Clinical trial multicenter double blind controlled placebo evaluation of poloxemer 188 in
sickle cell disease children experiencing vaso occlusive crisis
3. Incidence of Bone disease in survivor of childhood cancer
4. Pediatric Hodgkin Lymphoma retrospective study on children with Hodgkin lymphoma
treated in KFM
1#Title: Pediatric Hodgkin Lymphoma: A Retrospective 10-Year Experience in Children
& Adolescents with Hodgkin LymphomaTreated in King Fahad Medical City (KFMC)
BACKGROUND
Treatment advances in pediatric Hodgkin’s lymphoma HL have progressed to the point
that most children and adolescents diagnosed with Hodgkin’s disease will enjoy long-term
disease free survival, although it was the fourth most common malignancy in Saudi
children as reported in Saudi cancer registry less information is available about pediatric
Non-Hodgkin Lymphoma and its outcome in Saudi Arabia. Pediatric Oncology department
is one of the major sections of comprehensive Cancer Centre in KFMC which start
accepting new cases of pediatric neoplasm including non-Hodgkin lymphoma in 2006 and
now it is consider second center in Saudi Arabia which provide comprehensive care for
children with cancer
Study Objectives:
to provide demographic data ,disease characteristics ,treatment protocol ,toxicity and
outcome of treatment in children & adolescents with Non-Hodgkin's lymphoma treated at
KFMC This study will form base line for future studies about pediatric Non-Hodgkin's
lymphoma in KFMC which may help to improve outcome for children with cancer in Saudi
Arabia
Study patients and Method
We retrospectively analyzed 30 children and adolescents diagnosed to have Hodgkin’s
lymphoma at KFMC between December 2006 and December 2015, Follow-up will be
updated in January 2016.
Results;
Of the30 patients 21 (70 %) were boys and 9 (30 %) were girls, M: F ratio was 2.6; 1.
The median age was 9 years (range: 3-14 years), The majority of patients (46.7 %) were
aged between 5 and 12 years, The most common histological subtype was Nodular sclerosis
(60 %) followed by mixed cellularity (30%),Most frequently involved nodal site was
Cervical in 97% of patients; followed by Abdominal & retroperitoneal lymph node (63.7%)
also mediastinal lymph node (56.7%) B-symptoms were reported in (36.7%) Other highrisk features, including bulky disease at diagnosis were present in (53.3%), mediastinal
mass was observed in (26.7%).
Most of the children presented with advanced Stage III and IV (70%), patients were
divided to 3 Risk stratifications -low risk (LR) group treatment group received 4 cycles of
ABVD2 - intermediate risk group (IR) group received 4 cycles of ABVE-PC and high risk
group (HR) group received 4 cycles of BEACOPP then either ABVD or COPP/ABV
according to gender and early response
Majority of patients were assigned to
intermediate risk treatment group (50 %) While low risk group (16.7%) and high risk
group (n=10, 33.3%).76.7% of patients were early responders RER after 2 cycles of
chemotherapy while 23.3 % were slow responders SER, Patients who were slow early
responders SER after 2 cycles OR with bulky disease received involved field radiotherapy
(IFRT )21 Gy in 14 fractions of 1.5 Gy beginning 2 to 4 weeks after completion of all
chemotherapy Radiotherapy was delivered to 10 patients (33.3%) majority them was in in
intermediate risk group (40%,only (3.3%) of low risk patients and (30%) of high risk
group .The median follow-up in patients not experiencing an adverse event was 60.0months
(range:11-113) 3-years EFS and OS. The estimated 3-year EFE and OS rates in the entire
cohort of patients with newly diagnosed HL treated in the KFMC were 60 % 93.3%
respectively.
Conclusion
Though most of our patients presented in advanced Stage of the disease, the outcomes and
survival in our small series appeared to be accepted compared with international trial,
there are some limitations of our study including small sample size and Retrospective
design and future prospective studies with larger sample size will be needed to confirm our
results.
Key words: Non-Hodgkin lymphoma, disease, patients, children and adolescents
2#Title: Pediatric Non-Hodgkin Lymphoma: A Retrospective 7-Year Experience in
Children& Adolescents with Non-Hodgkin Lymphoma Treated in King Fahad Medical
City (KFMC)
Abstract
Background: Non-Hodgkin’s lymphoma is an aggressive malignant disease in children and
adolescents. Although it is the fourth most common malignancy in Saudi children as
reported in Saudi cancer registry, less information is available about pediatric NonHodgkin lymphoma and its outcome in Saudi Arabia. Study Objectives: To provide
demographic data, disease characteristics, treatment protocol, toxicity and outcome of
treatment in children & adolescents with Non-Hodgkin’s lymphoma treated at KFMC.
This study will form base line for future studies about pediatric Non-Hodgkin’s lymphoma
in KFMC, which may help to improve outcome for children with cancer in Saudi Arabia.
Study Patients and Method: We retrospectively analyzed 28 children and adolescents
diagnosed to have Non-Hodgkin’s lymphoma at KFMC between December 2006 and
December 2013, followed-up through June 2014. Results: Of the 28 patients, 10 (35.7%)
girls and 18 (64.3%) boys, the male-to-female ratio was 1.8; 1. The median age at time of
diagnosis was 6.4 years old (range 2.0 to 13.0 years old). The majority of patients (64.3%)
were aged between 5 and 12 years old. Burkitt’s lymphoma BL/BLL was the most common
pathological subtype (60.7%), and DLBCL was the second most common subtype (21.4%).
Abdominal and Retroperitoneal involvement was the most common primary site (78.6%)
including the ileocaecal region. Most of the children presented with advanced Stage III and
IV (75%), Cytogenetic study which screens specifically for the t (8; 14) (q24; q32) a
characteristic genetic feature of Burkitt’s Lymphoma was obtained from 21 patients,
variant rearrangement was observed in 3/21 samples and complex chromosomes karyotype
in addition to IGH/MYC rearrangement was observed in 2/21 samples
Those patients presented with very aggressive lymphoma and combined BM and CNS
involvement. We use the French-American-British Mature B-Cell Lymphoma 96 Protocol
(FAB LMB 96) for treatment for newly diagnosed Mature B-Cell type NHL and high risk
ALL CCG 1961 Protocol for lymphoblastic lymphoma and international Anaplastic Large
Cell Lymphoma 99 Study Protocol for ALCL. The median follow-up in patients not
experiencing an adverse event was 53.1 months. The estimated 3-year EFE and OS rates in
the entire cohort of patients with newly diagnosed NHL treated in the KFMC were 85.2%
and 89.2% respectively; Overall survival (OS) rate of patients with mature B-cell-NHL was
88.9%. Conclusion: The outcomes and survival in our small series appeared to be excellent
compared with those reported in other international trials even though most of our patients
presented in advanced stage of the disease. We feel that the importance of the current study
is to document the relative distribution of various types of pediatric non-Hodgkin’s
Lymphomas and age-specific distribution in different Histological subtypes.