Malawi pilot study of Burkitt lymphoma treatment

Hesseling, Peter; Broadhead, Robin L.; Molyneux, Elizabeth; Borgstein, Eric; Schneider, Johann; Louw, Mercia; Mansvelt, E. P. G.; Wessels, G.

doi:10.1002/mpo.10322

Cited by 70 publications

(78 citation statements)

References 6 publications

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“…These findings were consistent with similar studies which concluded that there was no statistically significant association between non compliance and low per capita family income [11,12]. The level of education and knowledge of the disease of the guardians were also shown to have no statistical significance in relation to adherence which is similar to some studies where demographic factors such as level of education, knowledge of the disease and race were found to have no association with adherence [14].…”

Section: Cumulative Doses Of Doxorubicin Usedsupporting

confidence: 82%

“…Table 9: Cumulative doses of doxorubicin Discussion A total of nineteen patients were included in the study of which most of (68.4%) the patients were male at (n=13). This is similar to most studies done in Kenya by Mwanda, et al and similar studies done in Uganda and Malawi which showed males being more susceptible to the disease than females [9][10][11].…”

Section: Knowledge Assessmentsupporting

confidence: 78%

See 1 more Smart Citation

Challenges in the Pharmacological Management of Non Hodgkin’s Lymphoma in Children in the Maintenance Phase of Therapy at Kenyatta National Hospital

Ww¹,

Karimi²,

Githinji³

et al. 2016

Journal of Cancer science and Clinical Oncology

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Section: Cumulative Doses Of Doxorubicin Usedsupporting

confidence: 82%

Section: Knowledge Assessmentsupporting

confidence: 78%

Challenges in the Pharmacological Management of Non Hodgkin’s Lymphoma in Children in the Maintenance Phase of Therapy at Kenyatta National Hospital

Ww¹,

Karimi²,

Githinji³

et al. 2016

Journal of Cancer science and Clinical Oncology

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“…The age range of patients with BL was 2.5-13 years, with peak age of incidence in the 1st decade of life, predominantly affecting boys. BL is a common childhood malignancy in a number of African countries 21,24 . The Epstein-Barr virus is consistently found in tumour cells of BL 3 , which is endemic in East and Central Africa, where it is considered an aetiologic factor with malaria also considered a pathogenic co-factor 9,13,37 .…”

Section: Discussionmentioning

confidence: 99%

Primary malignant neoplasms of orofacial origin: a retrospective review of 256 cases in a Nigerian tertiary hospital

Ajayi

Adeyemo

Ladeinde

et al. 2007

International Journal of Oral and Maxillofacial Surgery

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“…Malawi pilot study of BL treatment [15] Our hypothesis was that it would be possible to improve the cure rate of eBL patients with St Jude stages I, II and III eBL, by treatment with a chemotherapy schedule that was based on the LMB 89 Group B protocol, but of reduced intensity, and by providing matching supportive care.…”

mentioning

confidence: 99%

Burkitt lymphoma treatment: the Malawi experience

Hesseling

2009

J Afr Cancer

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L'objectif des études sur le lymphome de Burkitt (LB) au Malawi était de développer un traitement efficace et abordable dans une situation de ressources limitées. Dans l'étude du Malawi Pilot Study, 44 patients, atteints de LB de stades I, II et III de la classification de Saint-Jude, étaient traités par une chimiothérapie de densité moyenne basée sur la séquence et l'utilisation des médicaments selon le protocole LMB 89. Cinquante-sept pour cent du taux de survie globale étaient néanmoins associés aux décès liés à la toxicité du traitement chez 32 % des patients. Quarante des 92 patients, atteints de LB confirmé et qui ont été autorisés à quitter l'hôpital de leur vivant et traités par cyclophosphamide (CPM) seulement, étaient vivants lors de visite à domicile après 29-104 mois. Dans les études au Malawi, en 2002 (146 patients) et en 2003 (149 patients), le CPM à une dose de 40 mg/kg fut administré par voie intraveineuse ou par voie orale tous les sept jours × 3, additionné à du méthotrexate intrathécal, suivi par trois doses additionnelles de CPM tous les 14 jours en stades II et IV. La fourchette de survie, prévue selon la courbe de Kaplan-Meier, était de 45-52 %. Dans l'étude au Malawi en 2006 (40 patients), tous les stades étaient traités par CPM à une dose de 40 mg/kg au jour 1, suivi par CPM à une dose de 60 mg/kg aux jours 8, 18 et 28 et concomitante au méthotrexate interthécal. Dix-neuf (48 %) patients présentèrent une rémission continue après une médiane de 454 jours. Le coût de la chimiothérapie était de moins de 50 dollars US. Vingt-huit patients, avec une réponse incomplète à une chimiothérapie primaire ou qui présentaient une rémission, ont bénéficié d'un protocole de sauvetage par du CPM à une dose de 60 mg/kg, de la vincristine à une dose de 1,5 mg/m 2 , du méthotrexate intrathécal à une dose de 12,5 mg et de l'hydrocortisone à une dose de 12,5 mg aux jours 1, 8, 18 et 28. Ainsi, un taux de guérison global de 65 % peut être atteint par un traitement par le protocole du Malawi 2003 pour le LB suivi du protocole de sauvetage du Malawi en cas de nécessité. Mots clés Lymphome de Burkitt · Prise en chargeAbstract The objective of the Malawi Burkitt lymphoma (BL) studies was to develop effective and affordable treatment in a setting of limited resources. In the Malawi Pilot Study 44 BL patients with St Jude stages I, II and III were treated with medium intensity chemotherapy based on the sequence and drugs used in the LMB 89 protocol. The 57% overall survival rate was however associated with treatment toxicity related deaths in 32% of patients. Forty of ninety two patients with confirmed BL discharged from hospital alive and treated with cyclophosphamide (CPM) only, were found alive on home visit 29-104 months later. In the Malawi 2002 (146 patients) and 2003 (149 patients) studies i.v or oral CPM 40 mg/kg was given at 7-day intervals × 3 together with intrathecal methotrexate (MTX), followed in stages III and IV by 3 more doses of CPM at 14-day intervals. The projected Kaplan-Meier survival ranged from...

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Malawi pilot study of Burkitt lymphoma treatment

Abstract: It is possible to administer less intense and less costly multiagent chemotherapy to children with BL in a developing society with acceptable EFS rates. Adequate supportive care of the at-times associated severe toxicity must be made available to better the results.

Cited by 70 publications

References 6 publications

Challenges in the Pharmacological Management of Non Hodgkin’s Lymphoma in Children in the Maintenance Phase of Therapy at Kenyatta National Hospital

Challenges in the Pharmacological Management of Non Hodgkin’s Lymphoma in Children in the Maintenance Phase of Therapy at Kenyatta National Hospital

Primary malignant neoplasms of orofacial origin: a retrospective review of 256 cases in a Nigerian tertiary hospital

Burkitt lymphoma treatment: the Malawi experience

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