BACKGROUND: Treatment for Burkitt's lymphoma at Red Cross Children's Hospital has evolved from the use of aggressive surgery and less intensive chemotherapy to a conservative surgical approach with more intensive chemotherapy. METHODS: The study was a retrospective folder review of patients diagnosed with Burkitt's lymphoma at RCCH between 1984 and 2004. RESULTS: Ninety-two children were treated for Burkitt's lymphoma at RCCH between 1984 and 2004. There were 10 patients with group A or fully resected disease, 52 with group B or extensive localised disease, and 30 with dissemination to the bone marrow and/or central nervous system or group C disease. Protocol 1 (less intensive chemotherapy based on the COMP regimen) was used from 1984, with protocol 2 (more intensive chemotherapy based on the LMB regimen) introduced in 1988 for group C disease, 1991 for group B disease and 1996 for group A disease. Overall 5-year survival increased from 20% with protocol 1 to 66% with protocol 2 for group C disease, and from 76.5% with protocol 1 to 88.2% with protocol 2 for group B disease. There were more admissions for neutropenic fever in patients on protocol 2 and more episodes of mucositis, and these patients required more red cell and platelet transfusions. With a more conservative surgical approach, biopsy largely replaced attempts to partially resect the tumour at primary surgery, and there was a consequent decline in surgical complications. CONCLUSIONS: Intensive chemotherapy with protocol 2 has resulted in improved survival for group C and group B patients, but with more morbidity. Protocol 1, which is less intensive with less morbidity, remains a viable strategy for group A and group B disease in resource-poor settings.
BACKGROUND: Treatment for Burkitt's lymphoma at Red Cross Children's Hospital has evolved from the use of aggressive surgery and less intensive chemotherapy to a conservative surgical approach with more intensive chemotherapy. METHODS: The study was a retrospective folder review of patients diagnosed with Burkitt's lymphoma at RCCH between 1984 and 2004. RESULTS: Ninety-two children were treated for Burkitt's lymphoma at RCCH between 1984 and 2004. There were 10 patients with group A or fully resected disease, 52 with group B or extensive localised disease, and 30 with dissemination to the bone marrow and/or central nervous system or group C disease. Protocol 1 (less intensive chemotherapy based on the COMP regimen) was used from 1984, with protocol 2 (more intensive chemotherapy based on the LMB regimen) introduced in 1988 for group C disease, 1991 for group B disease and 1996 for group A disease. Overall 5-year survival increased from 20% with protocol 1 to 66% with protocol 2 for group C disease, and from 76.5% with protocol 1 to 88.2% with protocol 2 for group B disease. There were more admissions for neutropenic fever in patients on protocol 2 and more episodes of mucositis, and these patients required more red cell and platelet transfusions. With a more conservative surgical approach, biopsy largely replaced attempts to partially resect the tumour at primary surgery, and there was a consequent decline in surgical complications. CONCLUSIONS: Intensive chemotherapy with protocol 2 has resulted in improved survival for group C and group B patients, but with more morbidity. Protocol 1, which is less intensive with less morbidity, remains a viable strategy for group A and group B disease in resource-poor settings.
Authors: Geoffrey Buckle; Louise Maranda; Jodi Skiles; John Michael Ong'echa; Joslyn Foley; Mara Epstein; Terry A Vik; Andrew Schroeder; Jennifer Lemberger; Alan Rosmarin; Scot C Remick; Jeffrey A Bailey; John Vulule; Juliana A Otieno; Ann M Moormann Journal: Int J Cancer Date: 2016-05-18 Impact factor: 7.396
Authors: Osita U Ezenwosu; Barth F Chukwu; Okechukwu C Okafor; Anthony N Ikefuna; Ifeoma J Emodi Journal: Afr Health Sci Date: 2019-12 Impact factor: 0.927