The Cameroon 2008 burkitt lymphoma protocol: Improved event-free survival with treatment adapted to disease stage and the response to induction therapy

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dc.contributor.authorHesseling, P. B.
dc.contributor.authorNjume, E.
dc.contributor.authorKouya, F.
dc.contributor.authorKatayi, T.
dc.contributor.authorWharin, P.
dc.contributor.authorTamannai, M.
dc.contributor.authorAchu, P.
dc.contributor.authorKidd, M.
dc.contributor.authorMcCormick, P.
dc.date.accessioned2012-04-12T08:21:53Z
dc.date.available2012-04-12T08:21:53Z
dc.date.issued2012
dc.description.abstractTreatment of endemic Burkitt lymphoma (BL) with cyclophosphamide (CPM) and intrathecal methotrexate (IT MTX) can cure 50% of patients. In this study, induction therapy with CPM and IT MTX was followed by consolidation chemotherapy adapted for stage, clinical response, and abdominal ultrasound findings. One hundred and twenty-nine consecutive patients with BL, 77 male and 52 female with a median age of 7.9 years, were treated in mission hospitals in Cameroon. The diagnosis rested on fine-needle aspirate (79%), biopsy, bone marrow, cerebrospinal fluid, abdominal ultrasound, and clinical examination. Six percent had St Jude stage I, 13% stage II, 72% stage III, and 12% stage IV disease. The abdomen (76%) and face (50%) were mainly involved. Induction chemotherapy was CPM 40 mg/kg and IT MTX 12.5 mg and IT hydrocortisone 12.5 mg on days 1, 8, and 15. Stage I and II patients received CPM 60 mg/kg on day 29, and stage III patients CPM 60 mg/kg on days 29 and 43 if in remission on day 28. Stage IV patients and patients not in remission received CPM 60 mg/kg on days 29, 43, and 57 and 1.0 g/m 2 MTX intravenous (IV) and vincristine 1.5 mg/m 2 IV on day 29. Event-free survival (EFS) at mean 365 days was 61% (n = 79) and 100% in stage I, 85% in stage II, 60% in stage III, and 27% in stage IV patients. Deaths (n = 24) were disease or treatment related and 26 patients relapsed (mean 135 days). Risk-adapted treatment achieved 61% 1-year EFS. © 2012 Informa Healthcare USA, Inc.
dc.identifier.citationPediatric Hematology and Oncology
dc.identifier.citation29
dc.identifier.citation2
dc.identifier.citation119
dc.identifier.citation129
dc.identifier.issn8880018
dc.identifier.other10.3109/08880018.2011.644881
dc.identifier.urihttp://hdl.handle.net/10019.1/20600
dc.subjectCameroon
dc.subjectEndemic Burkitt lymphoma
dc.subjectTreatment
dc.titleThe Cameroon 2008 burkitt lymphoma protocol: Improved event-free survival with treatment adapted to disease stage and the response to induction therapy
dc.typeArticle
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