Epidemiology of Burkitt's lymphoma in Enugu, Nigeria.

Forty-four children between 3 and 14 years of age with Burkitt's lymphoma were studied at the University of Nigeria Teaching Hospital, Enugu, Nigeria from November 1991 to March 1995. Mean age at presentation was 7.6 years with a male:female ratio of 2.7:1. Eighty-six per cent of the patients lived in a rural area. Of the 23 (52%) from Enugu State, 16 were living in contiguous local government areas with ten clustered round the middle of the year. All the children were of the lowest socio-economic class, 75% of them being in class V. The incidence of Burkitt's lymphoma was higher during the dry season and the period of high malaria transmission (p < 0.05). Abdominal tumour was the commonest mode of presentation (32% of patients). Thirty-six patients were treated with cyclophosphamide, Oncovin, methotrexate and predinisolone (COMP), five received cyclophosphamide alone and three had cyclophosphamide, methotrexate and prednisolone (CMP). Multi-drug regimens achieved better results which were significantly unrelated to the number of cycles of therapy received. Overall, 48% had complete and 35% partial remission, 23% relapsed and 16 (36%) patients died. The epidemiological characteristics of Burkitt's lymphoma in this study were similar to those in other tropical regions.