title: Results of treatment with CMA, a low intermediate regimen, in endemic Burkitt lymphomas in sub-Saharian Africa: experience of Côte d'Ivoire.
abstract: African Burkitt lymphomas (BL) are highly aggressive lymphomas mainly affecting children and young adults in Africa. This lymphoma was marked by its high sensitivity to chemotherapy in comparison to Sporadic Burkitt lymphoma. In this study, we evaluated the treatment response and survival of patients with CMA protocol. Eighty-five of the 105 children registered were evaluated for response; there were 46 boys and 39 girls, whose age at diagnosis ranged from 3 to 18 years (median 11 years), admitted to the Hematology National Teaching Hospital of Abidjan in the period 1998-2008 with a diagnosis of BL on histological review and who were given CMA chemotherapy with curative intent are included in this analysis. CMA protocol is a low intermediate regimen of 3 drugs [Cytarabin (ara-C), Methotrexate (MTX), and Cyclophosphamide] with CNS-directed treatment by intrathecal MTX, ara-C and corticosteroid. Fifty-five of 85 patients obtained CR after induction therapy and 10 after 3 supplementary cycle because of partial response. The overall complete remission was 76%. Fifty-three of patients were alive in first CR at a median survival rate period of 2 years (range 82 days to 9 years) and are continuously disease free from Burkitt lymphomas. Twelve patients relapse after CR and died of lymphoma progression. More than 32 patients died, as a result of lymphoma progression. Among the 32 dead, 10 were in Murphy stage IV and all the patients who presented bone marrow involvement died. The projected 5-year overall survival rate was 62%. In conclusion, CMA protocol shows the high sensitivity of African Burkitt lymphoma. This can be considered as a successful result for people living in poor socio-economic conditions with no health insurance.
authors.affiliation: Hematology National Teaching Hospital, 21 BP 632, Abidjan 21, Côte d'Ivoire. guskof@yahoo.fr
authors.forename: Gustave Kouassi
authors.initials: GK
authors.lastname: Koffi
authors.forename: Aissata
authors.initials: A
authors.lastname: Tolo
authors.forename: Danho Clotaire
authors.initials: DC
authors.lastname: Nanho
authors.forename: Emeraude
authors.initials: E
authors.lastname: N'dathz
authors.forename: Mathias Yao
authors.initials: MY
authors.lastname: Kouassi
authors.forename: Fatou Diago
authors.initials: FD
authors.lastname: N'Diaye
authors.forename: Boidy
authors.initials: B
authors.lastname: Kouakou
authors.forename: N'dogomo
authors.initials: N
authors.lastname: Meité
authors.forename: Romeo
authors.initials: R
authors.lastname: Ayemou
authors.forename: Mamadou
authors.initials: M
authors.lastname: Sekongo
authors.forename: Paul
authors.initials: P
authors.lastname: Kouehion
authors.forename: Mori
authors.initials: M
authors.lastname: Meité
authors.forename: Norbert Dagnekpo
authors.initials: ND
authors.lastname: Tea
authors.forename: Amadou
authors.initials: A
authors.lastname: Sangaré
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Sanogo
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D007560:Cote d'Ivoire; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D003520:Cyclophosphamide; D008727:Methotrexate