Clinical characteristics, treatment and outcome of childhood Burkitt's lymphoma at the Uganda Cancer Institute

Jackson Orem, Yusuf Mulumba, Sara Algeri, Rino Bellocco, Fred Wabwire Mangen, Edward Katongole Mbidde, Elisabete Weiderpass

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19 Scopus citations

Abstract

Burkitt's lymphoma (BL) is a major cause of death among Ugandan children. We studied clinical characteristics and outcomes of childhood BL over time at the Uganda Cancer Institute (UCI). A total of 1217 children (766 boys, 451 girls, mean age 6.69 years) diagnosed with BL between 1985 and 2005 were included. There were no significant changes in the proportion of boys and girls diagnosed, or in mean age at diagnosis. Facial tumor (n= 945, 77.65%) and abdominal disease (n= 842, 69.19%) were the most common presentations. The proportion of children presenting with hepatic mass, malignant pleocytosis, and advanced-stage (stage C and D) BL increased during the study period (P<0.01). A total of 1085 children out of 1206 (89.97%) received at least one cycle of chemotherapy, and 832 of 1099 (75.71%) demonstrated objective response (i.e. complete or partial remission). The most common symptoms at BL diagnosis were fever (n= 621, 51.03%), anemia (n= 593, 48.73%), and weight loss (n= 588, 48.32%). Significant increases in the proportion of children with fever, and significant changes in the proportion of children with anemia, night sweats and severe infection were observed. HIV positivity was 3.87%, but no substantial differences in the proportion of HIV-positive children were observed. Mortality was not significantly different over time: it was similar in boys and girls, higher in older children (compared with younger ones), in those with advanced-stage BL, and HIV-positive children, but lower in children with facial tumors compared with other tumor presentations, and among those who received chemotherapy.

Original languageEnglish (US)
Pages (from-to)717-726
Number of pages10
JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
Volume105
Issue number12
DOIs
StatePublished - Dec 2011
Externally publishedYes

Bibliographical note

Funding Information:
Financial support was provided by the Swedish International Development Cooperation agency (SIDA), Makerere University and Mulago Hospital Kampala, Uganda. The work reported in this paper was partially undertaken during the tenure of an Expertise Transfer Fellowship awarded by the International Agency for Research on Cancer (IARC) to Dr Weiderpass.

Keywords

  • Burkitt's lymphoma
  • Cancer
  • HIV
  • Mortality
  • Pediatrics
  • Uganda

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