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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Burkitt's lymphoma treatment in a rural hospital in Sierra Leone
Transactions of the Royal Society of Tropical Medicine and Hygiene, Volume 107, No. 10, Article trt069, Year 2013
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Description
Background: Sierra Leone is a low-income sub-Saharan country in the endemic Burkitt's lymphoma (BL) belt. We performed a prospective trial of a reduced-intensity chemotherapy protocol for the treatment of paediatric BL. Patients and methods: The trial included all children clinically diagnosed with BL between 2005 and 2008. Biopsy, bone-marrow aspiration, analysis of cerebrospinal fluid, abdominal ultrasound and plain x-ray of involved sites were performed when feasible. The treatment protocol was a first i.v. dose of cyclophosphamide (CPM) 40 mg/kg, followed by oral CPM weekly for two doses and then bimonthly to a total of six doses. Treatment was based on clinical diagnosis as it was several weeks before pathology results were available. Results: Eighty-seven patientswere included, with a median age 7 years and 4 months; 59/87 (67.8%) were boys. Nearly half (n 1/4 17, 42.5%), presented with moderate or severe malnutrition. Biopsywas performed in 44 patients, BL being verified in 36 (41.4% of all patients). Most children presented with advanced disease: 28 (32%) at stage II, 47 (54%) at stage III and 12 (13.8%) at stage IV. Most patients (71/87, 82%) initially responded to treatment, but just over half (47/87, 54%) experienced relapse and refractory disease. Forty patients (46%) in complete or partial clinical response were lost to follow-up. Conclusion: The outcome for BL in rural Sierra Leone according to this protocol is poor. Low-dose CPM was in effective. Constraintson performing complete diagnosis and staging, frequency of advanced disease at presentation and a high drop-out rate might explain our poor results. © The Author 2013. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved.
Authors & Co-Authors
San Roman, M.
Sierra Leone
St John of God Hospital
Aguilo, F.
Sierra Leone
St John of God Hospital
Spain, Barcelona
Sant Joan de Déu Hospital
Clapes, M.
Sierra Leone
St John of God Hospital
Sheku, Mohamed Gbeshay
Sierra Leone
St John of God Hospital
Dawoh, P.
Sierra Leone
St John of God Hospital
Mora, Jaume
Spain, Esplugues de Llobregat
Hospital Sant Joan de Déu Barcelona
Cruz, Ofelia
Spain, Esplugues de Llobregat
Hospital Sant Joan de Déu Barcelona
Statistics
Citations: 7
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.1093/trstmh/trt069
ISSN:
00359203
e-ISSN:
18783503
Research Areas
Cancer
Food Security
Health System And Policy
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Sierra Leone
Participants Gender
Male