Treatment of children with B‐cell non‐Hodgkin lymphoma in a low‐income country

Moleti, Maria Luisa; Al‐Hadad, Salma Abbas; Al‐Jadiry, Mazin Faisal; Al‐Darraji, Amir Fadhil; Al‐Saeed, Raghad Majid; Vellis, Annalisa De; Piciocchi, Alfonso; Uccini, Stefania; Foà, Robin

doi:10.1002/pbc.22905

Cited by 38 publications

(45 citation statements)

References 27 publications

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“…The impact of adapting a uniform collaborative treatment regimen for participating institutions in countries or continents with substantial inequalities has yet to be addressed . As a first step, we suggest evaluating the conditions at each center and then tailoring the regimen intensity accordingly.…”

Section: Discussionmentioning

confidence: 99%

Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

Peña‐Hernandez

Ortiz

Garrido

et al. 2019

Pediatric Blood & Cancer

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Background Treating B–non‐Hodgkin lymphoma (B‐NHL) in lower‐income countries is challenging because of imprecise diagnosis, the increased risk of fatal toxicity associated with advanced disease at presentation, and limited supportive care. Procedure Central American patients with newly diagnosed stage I or II B‐NHL received a modified Berlin–Frankfurt–Münster (BFM) regimen including a prephase (prednisone, cyclophosphamide) followed by A/B/A courses (A: cytarabine, dexamethasone, etoposide, ifosfamide, methotrexate, and intrathecal therapy; B: cyclophosphamide, dexamethasone, doxorubicin, methotrexate, and intrathecal therapy). Those with stage III or IV NHL received additional courses (B/A/B), intensified for stage IV disease by additional vincristine and methotrexate doses. Patients in poor condition received a second prephase treatment before their chemotherapy courses. Results Between March 2004 and June 2016, of 405 patients with B‐NHL, 386 (109 females) were eligible for treatment. Immunohistochemistry was performed in 177 cases (47.4%) and characterized the disease as mature B‐cell lymphoma. Stage distribution was as follows: I/II, 31 (8.1%); III, 252 (65.3%); IV, 93 (24.1%); 10 (2.6%) not available. The 3‐year overall survival was 70% for the whole group (86% for stages I/II, 75% for stage III, 58% for stage IV). Events included death during induction (34 patients, 8.8%), relapse/progression (46, 11.9%), death in remission (9, 2.3%), second malignancy (1, 0.26%), and death of unknown cause (1, 0.26%). Twenty‐three (6%) patients abandoned or refused therapy. Conclusions Approximately 70% of children with B‐NHL from Central America experienced long‐term, disease‐free survival with a modified BFM schedule. Toxic death and relapse/resistant disease were the main reasons for treatment failure.

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Section: Discussionmentioning

confidence: 99%

Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

Peña‐Hernandez

Ortiz

Garrido

et al. 2019

Pediatric Blood & Cancer

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“…However, dose and administration schedules vary considerably. Some low-income countries such as Brazil, Argentina, Lebanon and Iraq have reported improved survival rates of children with B-NHL, although the MTX dose did not exceed 2 g/m2 (17,18,28) . The present study demonstrates that it is possible to obtain satisfactory results with the use of MTX at a dose of 0.5 g/m2, because only two patients relapsed and the other ten died of infectious or metabolic complications before or at the beginning of treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical course and prognostic factors of children with Burkitt's lymphoma in a developing country: the experience of a single centre in Brazil

Cunha¹,

Oliveira²,

Gomes³

et al. 2012

Revista Brasileira De Hematologia E Hemoterapia

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Objective: Burkitt's lymphoma is the most common subtype of non-Hodgkin lymphoma in children. The aim of this study was to characterize the clinical course and prognostic factors of children and adolescents with Burkitt's lymphoma treated in the Hematology Unit of Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG). Methods: A retrospective cohort study was made of 50 consecutive cases of children and adolescents aged 16 years or less with Burkitt's lymphoma admitted between January 1981 and December 2007. Prognostic factors associated with death were evaluated using the Kaplan-Meier method and compared by the two-tailed log-rank test. Results: The median age at diagnosis was 4.7 years. Most patients had abdominal tumors (66.7%) and advanced disease (68.9%) at diagnosis. Thirty-eight patients (84.4%) achieved complete clinical remission and 33 (73.3%) were alive at the first remission. Twelve children (26.7%) died. The median follow-up was 35 months with the probability of overall survival being 73% (89.2% and 35.7% for patients with uric acid < 7 mg/dL and ≥ 7.0 mg/dL, respectively - p-value < 0.001). Uric acid was the only significant prognostic factor at diagnosis. Conclusion: Our findings confirm the favorable prognosis of children with Burkitt's lymphoma even when treated with intermediate doses of methotrexate (500 mg/m2). Survival was significantly lower for individuals with concentrations of uric acid > 7 mg/dL.

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“…Treatment of acute myeloid leukaemia involves combination chemotherapy to control systemic and bone marrow disease. The high rate of treatment abandonment, due to unaffordability and patients living long distances from facilities, the inability to provide optimum treatment due to unavailability of medication, and treatment-related complications due to inadequate supportive care, limit the survival prospects of patients with lymphoreticular neoplasms [19,20,85,86]. Given the growing burden of these cancers, health service investments in accurate staging, immunohistochemistry, radiotherapy and essential chemotherapeutic drugs are critical to their improved control.…”

Section: Introductionmentioning

confidence: 99%

Managing the changing burden of cancer in Asia

Sankaranarayanan

Ramadas

Qiao

2014

BMC Med

153

121

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Asia accounts for 60% of the world population and half the global burden of cancer. The incidence of cancer cases is estimated to increase from 6.1 million in 2008 to 10.6 million in 2030, due to ageing and growing populations, lifestyle and socioeconomic changes. Striking variations in ethnicity, sociocultural practices, human development index, habits and dietary patterns are reflected in the burden and pattern of cancer in different regions. The existing and emerging cancer patterns and burden in different regions of Asia call for political recognition of cancer as an important public health problem and for balanced investments in public and professional awareness. Prevention as well as early detection of cancers leads to both better health outcomes and considerable savings in treatment costs. Cancer health services are still evolving, and require substantial investment to ensure equitable access to cancer care for all sections of the population. In this review, we discuss the changing burden of cancer in Asia, along with appropriate management strategies. Strategies should promote healthy ageing via healthy lifestyles, tobacco and alcohol control measures, hepatitis B virus (HBV) and human papillomavirus (HPV) vaccination, cancer screening services, and vertical investments in strengthening cancer healthcare infrastructure to improve equitable access to services.

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Treatment of children with B‐cell non‐Hodgkin lymphoma in a low‐income country

Cited by 38 publications

References 27 publications

Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

Outcome of pediatric non‐Hodgkin lymphoma in Central America: A report of the Association of Pediatric Hematology Oncology of Central America (AHOPCA)

Clinical course and prognostic factors of children with Burkitt's lymphoma in a developing country: the experience of a single centre in Brazil

Managing the changing burden of cancer in Asia

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