Outcomes for paediatric Burkitt lymphoma treated with anthracycline-based therapy in Malawi

Details

• Alternative Title:
  Br J Haematol
• Personal Author:
  Stanley, Christopher C. ; Westmoreland, Kate D. ; Heimlich, Brett J. ; El-Mallawany, Nader K. ; Wasswa, Peter ; Mtete, Idah ; Butia, Mercy ; Itimu, Salama ; Chasela, Mary ; Mtunda, Mary ; Chikasema, Mary ; Makwakwa, Victor ; Kaimila, Bongani ; Kasonkanji, Edwards ; Chimzimu, Fred ; Kampani, Coxcilly ; Dhungel, Bal M. ; Krysiak, Robert ; Montgomery, Nathan D. ; Fedoriw, Yuri ; Rosenberg, Nora E. ; Liomba, George N. ; Gopal, Satish
• Description:
  Burkitt lymphoma (BL) is the most common paediatric cancer in sub-Saharan Africa (SSA). Anthracyline-based treatment is standard in resource-rich settings, but has not been described in SSA. Children ≤18 years of age with newly diagnosed BL were prospectively enrolled from June 2013 to May 2015 in Malawi. Staging and supportive care were standardized, as was treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) for six cycles. Among 73 children with BL, median age was 9·2 years (interquartile range 7·7-11·8), 48 (66%) were male and two were positive for human immunodeficiency virus. Twelve (16%) had stage I/II disease, 36 (49%) stage III and 25 (34%) stage IV. Grade 3/4 neutropenia occurred in 17 (25%), and grade 3/4 anaemia in 29 (42%) of 69 evaluable children. Eighteen-month overall survival was 29% (95% confidence interval [CI] 18-41%) overall. Mortality was associated with age >9 years [hazard ratio [HR] 2·13, 95% CI 1·15-3·94], female gender (HR 2·12, 95% CI 1·12-4·03), stage (HR 1·52 per unit, 95% CI 1·07-2·17), lactate dehydrogenase (HR 1·03 per 100 iu/l, 95% CI 1·01-1·05), albumin (HR 0·96 per g/l, 95% CI 0·93-0·99) and performance status (HR 0·78 per 10-point increase, 95% CI 0·69-0·89). CHOP did not improve outcomes in paediatric BL compared to less intensive regimens in Malawi.
• Subjects:
  Age Factors Anthracyclines Antineoplastic Combined Chemotherapy Protocols Burkitt Lymphoma Child Cyclophosphamide Doxorubicin Female Humans Male Neoplasm Staging Prednisone Prospective Studies Sex Factors Treatment Outcome Vincristine

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• Source:
  Br J Haematol. 173(5):705-712.
• Pubmed ID:
  26914979
• Pubmed Central ID:
  PMC4884132
• Document Type:
  Journal Article
• Funding:
  K01 TW009488/TW/FIC NIH HHS/United States ; U54 CA190152/CA/NCI NIH HHS/United States ; R25 TW009340/TW/FIC NIH HHS/United States ; P30 CA016086/CA/NCI NIH HHS/United States ; U2G PS001965/PS/NCHHSTP CDC HHS/United States ; U01 CA121947/CA/NCI NIH HHS/United States ; R21 CA180815/CA/NCI NIH HHS/United States
• Place as Subject:
  Malawi
• Volume:
  173
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2fbfa5f1df7e49ffc5ee90c491203e8bc3bd73e276f19a085585bc91d8193ff0
• Download URL:
  https://stacks.cdc.gov/view/cdc/39630/cdc_39630_DS1.pdf
• File Type:
  [PDF - 455.13 KB ]