title: Outcome and haemato-toxicity of two chemotherapy regimens for childhood non-Hodgkin's lymphoma in a Kenyan hospital.
abstract: BACKGROUND
  Effectiveness and toxicity of childhood cancer treatments have never been evaluated in Kenya since introduction of structured care in the early seventies.
  
  
  OBJECTIVE
  To evaluate effectiveness and toxicity of two treatment protocols for Non-Hodgkin's lymphoma (NHL).
  
  
  METHODS
  Historical cohort study using medical records.
  
  
  METHODS
  Kenyatta National Hospital, a tertiary care and medical teaching hospital.
  
  
  METHODS
  Children < or =15 years with diagnosis of non-Hodgkin's Lymphoma.
  
  
  METHODS
  Primary outcomes were median survival, event free survival and toxicity.
  
  
  RESULTS
  Out of 101 records, only 26 (25.7%) met inclusion criteria. Baseline characteristics were similar in the two treatment arms. Median survival was 0.75 months (95% CI = 0.54-0.96) and 1.0 months (95% CI = 0.29-1.71) for short and long arm groups. There was no difference in event free survival and haematological toxicity.
  
  
  CONCLUSIONS
  No clear difference in effectiveness and toxicity between the intensive-short and the less aggressive long course chemotherapy regimens was evident. Though lack of difference may be attributed to the small sample size, suboptimal supportive care for intensive treatment would increase risk of toxic deaths. As the short course protocol did not demonstrate obvious deterioration of median and event free survival, a strong case may be made for a randomised clinical trial within a context of improved supportive care.
authors: Department of Paediatrics and Child Health, Aga Khan University Hospital, P.O. Box 30270, 00100, Nairobi, Kenya.
authors: W M
authors: WM
authors: Macharia