BACKGROUND: Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in equatorial Africa and there is a need for affordable, effective treatment. AIM: To record the morbidity of treatment and event-free survival after 1 year using relatively high doses of cyclophosphamide at short intervals combined with intrathecal methotrexate. METHODS: Forty consecutive patients with a mean age of 6.9 (range 2-15) years were treated at Queen Elizabeth Central Hospital, Blantyre between 10th April and 17th November 2006. The initial diagnosis was made clinically and confirmed by fine-needle aspiration in 73%. Abdominal ultrasound, bone marrow aspirate and CSF analysis were undertaken routinely. Chemotherapy consisted of cyclophosphamide, 40 mg/kg on day 1 and 60 mg/kg on days 8, 18 and 28. Intrathecal methotrexate 12.5 mg and hydrocortisone 12.5 mg were administered on days 1, 8, 18 and 28. Allopurinol was commenced before chemotherapy, and a high urinary output was maintained to prevent tumour lysis. RESULTS: St Jude stage distribution was stage I, 1; II, 9; III, 24; and IV, 6. An equal number (70%) presented with abdominal and facial disease, and 15% with paraplegia. Twenty patients (50%) were below the 5th NCHS centile for weight-for-age. Two patients died during treatment, three had chemotherapy-resistant disease and 35 (88%) achieved complete clinical remission by day 28. Sixteen required antibiotic treatment for presumed infection and nine received a blood transfusion. Relapse occurred in 16 patients after 65-311 days (median 137). Nineteen patients (48%) have been in continued remission for 265-670 days (median 454). CONCLUSION: This short, inexpensive treatment schedule (<50 US$) cured almost 50% of eBL patients in a setting of very limited resources.
BACKGROUND: Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in equatorial Africa and there is a need for affordable, effective treatment. AIM: To record the morbidity of treatment and event-free survival after 1 year using relatively high doses of cyclophosphamide at short intervals combined with intrathecal methotrexate. METHODS: Forty consecutive patients with a mean age of 6.9 (range 2-15) years were treated at Queen Elizabeth Central Hospital, Blantyre between 10th April and 17th November 2006. The initial diagnosis was made clinically and confirmed by fine-needle aspiration in 73%. Abdominal ultrasound, bone marrow aspirate and CSF analysis were undertaken routinely. Chemotherapy consisted of cyclophosphamide, 40 mg/kg on day 1 and 60 mg/kg on days 8, 18 and 28. Intrathecal methotrexate 12.5 mg and hydrocortisone 12.5 mg were administered on days 1, 8, 18 and 28. Allopurinol was commenced before chemotherapy, and a high urinary output was maintained to prevent tumour lysis. RESULTS: St Jude stage distribution was stage I, 1; II, 9; III, 24; and IV, 6. An equal number (70%) presented with abdominal and facial disease, and 15% with paraplegia. Twenty patients (50%) were below the 5th NCHS centile for weight-for-age. Two patients died during treatment, three had chemotherapy-resistant disease and 35 (88%) achieved complete clinical remission by day 28. Sixteen required antibiotic treatment for presumed infection and nine received a blood transfusion. Relapse occurred in 16 patients after 65-311 days (median 137). Nineteen patients (48%) have been in continued remission for 265-670 days (median 454). CONCLUSION: This short, inexpensive treatment schedule (<50 US$) cured almost 50% of eBL patients in a setting of very limited resources.
Authors: George Chagaluka; Peter Carey; Kondwani Banda; Claire Schwab; Lucy Chilton; Ed Schwalbe; Roderick Skinner; Trijn Israels; Anthony Moorman; Elizabeth Molyneux; Simon Bailey Journal: Haematologica Date: 2012-08-16 Impact factor: 9.941
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Authors: Elizabeth A Morgan; M Patrick Sweeney; Tamiwe Tomoka; Nadja Kopp; Daniel Gusenleitner; Robert A Redd; Christopher D Carey; Leo Masamba; Steve Kamiza; Geraldine S Pinkus; Donna S Neuberg; Scott J Rodig; Danny A Milner; David M Weinstock Journal: Blood Adv Date: 2016-11-22
Authors: Peixun Zhou; Alex E Blain; Alexander M Newman; Masood Zaka; George Chagaluka; Filbert R Adlar; Ugonna T Offor; Casey Broadbent; Lewis Chaytor; Amber Whitehead; Amy Hall; Hettie O'Connor; Susan Van Noorden; Irvin Lampert; Simon Bailey; Elizabeth Molyneux; Chris M Bacon; Simon Bomken; Vikki Rand Journal: Blood Adv Date: 2019-07-23
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: Trijn Israëls; Joyce Kambugu; Francine Kouya; Nader Kim El-Mallawany; Peter B Hesseling; Gertjan J L Kaspers; Tim Eden; Lorna Renner; Elizabeth M Molyneux Journal: Nat Rev Clin Oncol Date: 2013-07-30 Impact factor: 66.675