Journal
PEDIATRIC BLOOD & CANCER
Volume 56, Issue 1, Pages 70-76Publisher
WILEY
DOI: 10.1002/pbc.22746
Keywords
Burkitt lymphoma; chemotherapy; children; cyclophosphamide monotherapy; non Hodgkin lymphoma; sub-saharan Africa
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Background The French African Group of Pediatric Oncology was set up to improve quality of care for children with cancer Preliminary observations on the efficacy in Burkitt lymphoma (BL) of a cyclophosphamide monotherapy (CPM) have been published We report the results of a multicentric prospective study combining first line CPM and a multidrug second line chemotherapy (SC) for refractory/relapsed patients Procedure Patients <= 18 years with Burkitt or Burkitt like lymphoma, were included in six countries (Burkina Faso, Cameroon Ivory Coast, Madagascar, Mali, and Senegal) All patients received three weekly CPM courses (1 2 g/m(2) IV with intrathecal methotrexate and hydrocortisone), stage 3/4 patients received three further courses SC added methotrexate, vincristine cytarabine, and prednisone Results There were 178 patients included (42 stage 1/2, 134 stage 3/4, and 2 unknown) Isolated facial localization was found in 41 patients, diffuse abdominal involvement in 120 patients including 65 with both Nine early deaths were reported, toxicity occurred in 136/743 courses (83 patients) and was predominantly hematological After CPM complete remission (CR) rate was 47% with a 33% EFS Because of rapid progression 76/108 eligible patients (85 primary refractory and 23 relapses) received SC resulting in 35 7% CR but a 21% toxic death rate The OS of the whole strategy was 50 5% and correlated to stage Conclusion A prospective multicentric study on BL was feasible in very low income countries CPM can be recommended in stage 1-2 because of optimal cost/benefit ratio However, more intensive strategies still adapted to socio economic conditions are required for advanced stages 3 and 4 Pediatr Blood Cancer 2011 56 70-76 (C) 2010 Wiley Liss Inc
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