Intrathecal chemoprophylaxis in the prevention of central nervous system relapse in Burkitt's lymphoma

Nkrumah, Francis; Neequaye, Janet; Biggar, Robert J.

doi:10.1002/1097-0142(19850715)56:2<239::aid-cncr2820560205>3.0.co;2-f

Cited by 14 publications

(7 citation statements)

References 7 publications

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“…Endemic BL is very sensitive to chemotherapy, particularly cyclophosphamide, as well as intrathecal methotrexate for central nervous system disease (Nkrumah et al , ; Traoré et al , ; Magrath, ; Molyneux et al , ). Sporadic BL in resource‐rich countries has a disease‐free survival (DFS) greater than 90% even in advanced stage disease (Patte et al , ; Gerrard et al , ) but this requires very intensive chemotherapy, which is neither feasible nor safe in most low‐income countries.…”

Section: Comparative Table Of Patient Details and Outcomes Using Malamentioning

confidence: 99%

The use of anthracyclines in the treatment of endemic Burkitt lymphoma

et al. 2016

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Summary 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.

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Section: Comparative Table Of Patient Details and Outcomes Using Malamentioning

confidence: 99%

The use of anthracyclines in the treatment of endemic Burkitt lymphoma

et al. 2016

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“…Finally, the presence of central nervous systemic disease does not necessarily lead to a poor outcome even in late stage disease, since intrathecal therapy and prophylaxis are effective in improving outcome. 13,14 In a long-term follow-up study by Olweny a complete response rate of 81% was observed after a 10-year follow-up: factors influencing remission duration and survival were the stage at which the disease was presented and the protocol used. 12 These findings have been the backbone of practice in Africa for over 30 years.…”

Section: Treatment Of Eblmentioning

confidence: 99%

Current investigations and treatment of Burkitt's lymphoma in Africa

2008

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We reviewed the scientific literature on Burkitt's lymphoma (BL) in Africa in order to provide information on the current status of clinical care and the existing research challenges. BL epidemiology led to the discovery of the Epstein Barr virus, an important cause of several viral illnesses and malignancies. The incidence of BL has increased in the endemic areas of Africa, overlapping with the epidemic of HIV and increase of malaria. The impact of this on the clinical care of BL in the region is therefore of interest, especially in HIV-infected children. Rapid methods must be developed which enable the correct diagnosis to be made. It is important to improve supportive care to allow fairly aggressive treatment, to research into salvage therapy for those who fail first-line treatment, and to develop less toxic drug combinations for HIV-infected patients. Documentation of HIV status through counselling should be offered to all patients.

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“…It is extremely chemosensitive and localised tumours can be cured with cyclophosphamide (CPM) monotherapy . Central nervous system (CNS) relapses can be reduced by two‐thirds by giving prophylactic intrathecal chemotherapy . However, most patients present with advanced disease which is challenging to treat.…”

Section: Introductionmentioning

confidence: 99%

“…[3,4] Central nervous system (CNS) relapses can be reduced by two-thirds by giving prophylactic intrathecal chemotherapy. [5,6] However, most patients present with advanced disease which is challenging to treat. Survival of sporadic BL in resource-rich countries is over 90% using intensive chemotherapy protocols.…”

Section: Introductionmentioning

confidence: 99%