Treatment of B-cell lymphoma with LMB modified protocols in Africa--report of the French-African Pediatric Oncology Group (GFAOP).
BACKGROUND
The French African Paediatric Oncology Group (GFAOP) was set up in October 2000 to improve the quality of care of children with cancer in Africa. Eight pediatric oncology units from Algeria, Cameroon, Madagascar, Morocco, Tunisia, and Senegal have been involved.


METHODS
Patients less than 18 years with cytology or histology proven B-cell non-Hodgkin lymphoma were included. Two LMB89 modified regimens were proposed (MAT and GFA).


RESULTS
From April 2001 to April 2004, 343 cases were registered. Thirty seven patients were excluded. Thirteen patients were stage I, 26 stage II, 209 stage III and 50 stage IV including 8 L3 acute lymphoblastic leukemia (ALL3) cases. Three year OS of the whole population of patients is 61%. In GFA group 36 months OS is 63.6% in stages I/II, 51.6% in stage III and 35.8% in stage IV. In MAT group, the OS is 84.4% in stages I/II, 76.2% in stage III and 55.6% in stage IV. Seventy one patients died during treatment, 32 at pre-induction phase, 27 at induction and 12 at consolidation. Treatment related mortality decreased during the 3-year inclusion period (first year: 25.7%, second year: 19.1%, third year: 11.6%). The improvement of supportive care translated into an increase of the overall survival rates from 54% in the first year to 73% in the third year.


CONCLUSIONS
These data demonstrate the feasibility of prospective multicentric studies in Africa. An improvement of quality of care has been noticed during the 3 first years.
Harif
Mhamed
M
Service d'Hématologie et Oncologie Pédiatrique, Hôpital 20 Août 1953, Casablanca, Morocco. m.harif@menara.ma
Barsaoui
Sihem
S
Benchekroun
Said
S
Bouhas
Rachid
R
Doumbé
Pierre
P
Khattab
Mohammed
M
Ladjaj
Yasmina
Y
Moreira
Claude
C
Msefer-Alaoui
Fouzia
F
Patte
Catherine
C
Rakotonirina
Gervais
G
Raphael
Martine
M
Raquin
Marie-Anne
MA
Lemerle
Jean
J
D000293:Adolescent; D000352:Africa, Northern / Q000453:epidemiology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D003561:Cytarabine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D016393:Lymphoma, B-Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D015996:Survival Rate
D003561:Cytarabine; D003520:Cyclophosphamide; D008727:Methotrexate