Clinical course and prognostic factors of children with Burkitt's lymphoma in a developing country: the experience of a single centre in Brazil

Abstract

Objective: Burkitt's lymphoma is the most common subtype of non-Hodgkin lymphoma in children. The aim of this study was to characterize the clinical course and prognostic factors of children and adolescents with Burkitt's lymphoma treated in the Hematology Unit of Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG). Methods: A retrospective cohort study was made of 50 consecutive cases of children and adolescents aged 16 years or less with Burkitt's lymphoma admitted between January 1981 and December 2007. Prognostic factors associated with death were evaluated using the Kaplan-Meier method and compared by the two-tailed log-rank test. Results: The median age at diagnosis was 4.7 years. Most patients had abdominal tumors (66.7%) and advanced disease (68.9%) at diagnosis. Thirty-eight patients (84.4%) achieved complete clinical remission and 33 (73.3%) were alive at the first remission. Twelve children (26.7%) died. The median follow-up was 35 months with the probability of overall survival being 73% (89.2% and 35.7% for patients with uric acid < 7 mg/dL and ≥ 7.0 mg/dL, respectively - p-value < 0.001). Uric acid was the only significant prognostic factor at diagnosis. Conclusion: Our findings confirm the favorable prognosis of children with Burkitt's lymphoma even when treated with intermediate doses of methotrexate (500 mg/m2). Survival was significantly lower for individuals with concentrations of uric acid > 7 mg/dL.

Pediatric mature B-cell NHL, early referral and supportive care problems in a developing country

“…Overall, the demographic and clinical baseline characteristics of our patients do not have a significant deviation from the literature [4,[7][8][9][10]. However, the high percentage of patients with stage III and IV disease is of note, which is concordant with what has been reported in other lower and middle-income countries [11,12].…”

“…The incidence of grade 3 and 4 acute toxicities was also similar to that reported in the literature and expected due to the aggressiveness of the disease and the type of treatment required [4,7]. Outcomes for stage III and IV were well below those reported in developed countries [10,14] but were similar to those reported for low and middle-income countries [8,9,12,15,16], which might be explained by our economic disparity. Despite Mexico belongs to an upper middle-income category, our country has striking levels of income disparity.…”

Outcome of children and adolescents with lymphoblastic lymphoma

“…Burkitt's lymphoma is the leading subtype in our institution. 22 In agreement with the literature, the most frequent phenotype among our patients had T-cell origin. Approximately 20% were of pB-cell origin, and the remaining were unclassified.…”

Outcome of children and adolescents with lymphoblastic lymphoma

“…Burkitt's lymphoma is the leading subtype in our institution. 22 In agreement with the literature, the most frequent phenotype among our patients had T-cell origin. Approximately 20% were of pB-cell origin, and the remaining cases were unclassified.…”