Abstract | BACKGROUND: We previously reported a 28-day treatment protocol for children with endemic Burkitt lymphoma (BL) which included four doses of cyclophosphamide (CPM), intrathecal methotrexate and hydrocortisone (IT MTX/HC) at Queen Elizabeth Central Hospital (QECH) in Malawi which resulted in an Event-Free Survival (EFS) of 50% at 1 year. METHODS: In an attempt to improve survival whilst maintaining acceptable toxicity, brevity, low-cost and a standard treatment for all patients, four doses of vincristine (VCR) at 1.5 mg/m(2) were added to the backbone of CPM 40 mg/kg on day 1 and 60 mg/kg on days 8,18 and 28 and IT MTX /HC 12.5 mg on days 1,8,18 and 28. RESULTS: Seventy cytology confirmed cases of BL, 42 males and 28 females with a median age of 80 years, were treated with this protocol between January 2010 and April 2012. Four percent had St Jude Stage I disease; 29% Stage II; 30% Stage III and 37% Stage IV. Disease site in order of frequency was face (64%); abdomen (47%); CSF (26%) and paraspinal (17%). There were two on-treatment deaths. Sixty-three percent required antibiotics and 19% required blood transfusion. Eighty-one percent of patients achieved complete clinical remission at day 28. Overall predicted EFS at 1 year was 48%; 100% in Stage I, 83% in Stage II, 24% in Stage III and 32% in Stage IV disease. EFS was significantly worse in patients with Stage III/IV disease (P = 0.002) and paraplegia (P = 0.002). CONCLUSION: The addition of vincristine to the Malawi 28 day BL treatment protocol did not improve survival.
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Authors | Sarita Depani, Kondwani Banda, Simon Bailey, Trijn Israels, George Chagaluka, Elizabeth Molyneux |
Journal | Pediatric blood & cancer
(Pediatr Blood Cancer)
Vol. 62
Issue 11
Pg. 1929-34
(Nov 2015)
ISSN: 1545-5017 [Electronic] United States |
PMID | 26052841
(Publication Type: Clinical Trial, Journal Article)
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Copyright | © 2015 Wiley Periodicals, Inc. |
Chemical References |
- Vincristine
- Cyclophosphamide
- Hydrocortisone
- Methotrexate
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Topics |
- Adolescent
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage)
- Burkitt Lymphoma
(drug therapy, epidemiology, mortality)
- Child
- Child, Preschool
- Cyclophosphamide
(administration & dosage)
- Disease-Free Survival
- Endemic Diseases
- Female
- Humans
- Hydrocortisone
(administration & dosage)
- Malawi
(epidemiology)
- Male
- Methotrexate
(administration & dosage)
- Neoplasm Staging
- Survival Rate
- Vincristine
(administration & dosage)
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