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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Malnutrition and neutropenia in children treated for burkitt lymphoma in Malawi
Pediatric Blood and Cancer, Volume 53, No. 1, Year 2009
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Description
Background. Infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with limited toxicity. The aim of this study was to evaluate the incidence and outcome of febrile neutropenia during this treatment and the association with malnutrition at diagnosis. Methods. We documented nutritional status, febrile and/or neutropenic episodes, antibiotic therapy and short term outcome of all children with Burkitt lymphoma treated according to the local protocol and admitted from January 2007 to March 2008. Results. Fifty eight (69%) of 84 patients were acutely malnourished at diagnosis with an arm muscle area (AMA) below the 5 th percentile. Malnutrition at diagnosis was associated with a significantly higher rate of profound neutropenia. This association remained significant (OR 12; 95% C.I. 1.5 - infinitely; P = 0.012) after control for clinical stage of disease, bone marrow involvement and HIV infection which are possible confounders. All patients with profound neutropenia, prolonged neutropenia and treatment related deaths were malnourished at diagnosis. Four (4.9%) of 81 patients died of treatment related causes; three of them due to a Gram negative septicaemia. Conclusion. Acute malnutrition at diagnosis is associated with significantly more treatment related profound neutropenia. The intensity of chemotherapeutic regimens has to be adapted to the level of available supportive care and patients' nutritional status and tolerance to avoid unacceptable morbidity and mortality. This local treatment protocol for Burkitt lymphoma has a treatment related mortality of 5% in patients in Malawi. © 2009 Wiley-Liss, Inc.
Authors & Co-Authors
Israëls, Trijn
Malawi, Zomba
University of Malawi
Netherlands, Amsterdam
Emma Kinderziekenhuis
Van De Wetering, Marianne D.
Netherlands, Amsterdam
Emma Kinderziekenhuis
Hesseling, Peter Bernard
South Africa, Stellenbosch
Stellenbosch University
Van Geloven, Nan
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Caron, Huib N.
Netherlands, Amsterdam
Emma Kinderziekenhuis
Molyneux, Elizabeth M.
Malawi, Zomba
University of Malawi
Statistics
Citations: 86
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1002/pbc.22032
ISSN:
15455009
e-ISSN:
15455017
Research Areas
Cancer
Food Security
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Malawi