title: The use of anthracyclines in the treatment of endemic Burkitt lymphoma.
abstract: Burkitt lymphoma is the most common malignancy in children in Malawi, the world's poorest country, where there is a long history of treating this disease using a 28-day cyclophosphamide-based protocol. Stage III/IV disease has had poor outcomes. In an attempt to improve the outcome for higher stage disease, anthracyclines were added to the existing protocol. The disease-free (DFS) and overall survival (OS) of 58 children with cytologically confirmed Burkitt lymphoma admitted during 2012-2014 and treated using this protocol were calculated. Six (10%) children had stage I disease, ten (17%) stage II and 42 stage III or IV (73%). Overall 12-month DFS (OS) was 68·5% (72·9%); for stage I disease 100% (100%), stage II 56·2% (60%), stage III/IV 66·3% (72·2%). The DFS was significantly improved from the previous protocol (P = 8 × 10-4). The addition of doxorubicin to stage III and IV disease resulted in a markedly improved DFS. Anthracyclines are deliverable in resource-poor settings and possibly improve the survival of children with Burkitt lymphoma.
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital and College of Medicine, Blantyre, Malawi.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Molyneux
authors.affiliation: Department of Applied Sciences, University of Northumbria, Newcastle upon Tyne, UK.
authors.forename: Ed
authors.initials: E
authors.lastname: Schwalbe
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: George
authors.initials: G
authors.lastname: Chagaluka
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors.forename: Kondwani
authors.initials: K
authors.lastname: Banda
authors.affiliation: Department of Paediatric Oncology, VU Medical Centre, Amsterdam, the Netherlands.
authors.forename: Trijn
authors.initials: T
authors.lastname: Israels
authors.affiliation: University College Hospital, Paediatric and Adolescent Oncology, London, UK.
authors.forename: Sarita
authors.initials: S
authors.lastname: Depani
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital and College of Medicine, Blantyre, Malawi.
authors.forename: Kirstin
authors.initials: K
authors.lastname: Mittermayer-Vassallo
authors.affiliation: University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
authors.forename: Kevin
authors.initials: K
authors.lastname: Windebank
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital and College of Medicine, Blantyre, Malawi.
authors.forename: Jessie
authors.initials: J
authors.lastname: Mvula
authors.affiliation: Department of Paediatrics, Queen Elizabeth Central Hospital and College of Medicine, Blantyre, Malawi.
authors.forename: Jenala
authors.initials: J
authors.lastname: Njiram'madzi
authors.affiliation: Northern Institute of Cancer Research, Newcastle upon Tyne, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: O'Brien
authors.affiliation: Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Carey
authors.affiliation: Great North Childrens Hospital and University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Bailey
mesh_terms: D000293:Adolescent; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008507:Medically Underserved Area; D009367:Neoplasm Staging
chemical_list: D018943:Anthracyclines; D004317:Doxorubicin
keywords: Burkitt lymphoma; anthracyclines; chemotherapy; endemic; resource-challenged countries