Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique
PURPOSE: To evaluate the results of an intensive polychemotherapy regimen for Burkitt lymphoma (BL) in sub-Saharan African pediatric centers. PATIENTS AND METHODS: Children with advanced-stage BL (stages II bulky, III, and IV) treated with the GFAOP–Lymphomes Malins B (GFALMB) 2009 protocol in 7 cen...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American Society of Clinical Oncology
2019-12-01
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| Series: | Journal of Global Oncology |
| Online Access: | http://ascopubs.org/doi/10.1200/JGO.19.00172 |
| _version_ | 1828438259933380608 |
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| author | Gabrielle C. Bouda Fousseyni Traoré Line Couitchere Marie-Anne Raquin Koffi M. Guedenon Angele Pondy Claude Moreira Mbola Rakotomahefa Mhamed Harif Catherine Patte |
| author_facet | Gabrielle C. Bouda Fousseyni Traoré Line Couitchere Marie-Anne Raquin Koffi M. Guedenon Angele Pondy Claude Moreira Mbola Rakotomahefa Mhamed Harif Catherine Patte |
| author_sort | Gabrielle C. Bouda |
| collection | DOAJ |
| description | PURPOSE: To evaluate the results of an intensive polychemotherapy regimen for Burkitt lymphoma (BL) in sub-Saharan African pediatric centers. PATIENTS AND METHODS: Children with advanced-stage BL (stages II bulky, III, and IV) treated with the GFAOP–Lymphomes Malins B (GFALMB) 2009 protocol in 7 centers between April 2009 and September 2015 were prospectively registered. Treatment regimen contained a prephase with cyclophosphamide followed by 2 induction courses (cyclophosphamide, vincristine, prednisone, high-dose methotrexate [HDMTX]), 2 consolidation courses (cytarabine, HDMTX), and a maintenance phase only for stage IV. HDMTX was given at the dose of 3 g/m2. RESULTS: Four hundred patients were analyzed: 7% had stage II bulky, 76% stage III, and 17% stage IV disease. Median age was 7.3 years, and sex ratio was 1.9:1 (male:female). A total of 221 patients received the whole protocol treatment and 195 achieved complete remission (CR), 11 of them after a second-line treatment. Treatment abandonment rate was 22%. One hundred twenty-five patients died, of whom 49 deaths were related to treatment toxicity. A total of 275 patients are alive, including 25 despite treatment abandonment, but only 110 are known to be in CR with a follow-up > 1 year, indicating a high rate of loss to follow-up. Twelve-month overall survival (OS) was 60% (95% CI, 54% to 66%) and 63%, 60%, and 31%, respectively, for stage II bulky, III, and IV. Patients with stage III disease who started second induction course within 34 days had OS of 76%, versus 57% (P = .0062) beyond 34 days. CONCLUSION: The GFA-LMB2009 protocol improved patients’ survival. Early dose intensity of treatment is a strong prognostic factor. Improving supportive care and decreasing loss to follow-up are crucial. |
| first_indexed | 2024-12-10T20:00:28Z |
| format | Article |
| id | doaj.art-c5ba3683ce4f45398e089c874b6ffafd |
| institution | Directory Open Access Journal |
| issn | 2378-9506 |
| language | English |
| last_indexed | 2024-12-10T20:00:28Z |
| publishDate | 2019-12-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | Journal of Global Oncology |
| spelling | doaj.art-c5ba3683ce4f45398e089c874b6ffafd2022-12-22T01:35:32ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062019-12-0151910.1200/JGO.19.001721Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie PédiatriqueGabrielle C. Bouda0Fousseyni Traoré1Line Couitchere2Marie-Anne Raquin3Koffi M. Guedenon4Angele Pondy5Claude Moreira6Mbola Rakotomahefa7Mhamed Harif8Catherine Patte9CHU Yalgado Ouédraogo, Ouagadougou, Burkina FasoCHU Gabriel Touré, Bamako, MaliCHU de Treichville, Abidjan, Côte d’IvoireGustave Roussy Hospital and GFAOP Database Center, Villejuif, FranceCHU Sylvanus Olympio, Lomé, TogoCentre Mère-Enfant, Fondation Chantal Biya, Yaoundé, CamerounHôpital Aristide Le Dantec, Dakar, SénégalHJRA, Antananarivo, MadagascarHôpital 20 Août 1953, Casablanca, MoroccoGustave Roussy Hospital and GFAOP Database Center, Villejuif, FrancePURPOSE: To evaluate the results of an intensive polychemotherapy regimen for Burkitt lymphoma (BL) in sub-Saharan African pediatric centers. PATIENTS AND METHODS: Children with advanced-stage BL (stages II bulky, III, and IV) treated with the GFAOP–Lymphomes Malins B (GFALMB) 2009 protocol in 7 centers between April 2009 and September 2015 were prospectively registered. Treatment regimen contained a prephase with cyclophosphamide followed by 2 induction courses (cyclophosphamide, vincristine, prednisone, high-dose methotrexate [HDMTX]), 2 consolidation courses (cytarabine, HDMTX), and a maintenance phase only for stage IV. HDMTX was given at the dose of 3 g/m2. RESULTS: Four hundred patients were analyzed: 7% had stage II bulky, 76% stage III, and 17% stage IV disease. Median age was 7.3 years, and sex ratio was 1.9:1 (male:female). A total of 221 patients received the whole protocol treatment and 195 achieved complete remission (CR), 11 of them after a second-line treatment. Treatment abandonment rate was 22%. One hundred twenty-five patients died, of whom 49 deaths were related to treatment toxicity. A total of 275 patients are alive, including 25 despite treatment abandonment, but only 110 are known to be in CR with a follow-up > 1 year, indicating a high rate of loss to follow-up. Twelve-month overall survival (OS) was 60% (95% CI, 54% to 66%) and 63%, 60%, and 31%, respectively, for stage II bulky, III, and IV. Patients with stage III disease who started second induction course within 34 days had OS of 76%, versus 57% (P = .0062) beyond 34 days. CONCLUSION: The GFA-LMB2009 protocol improved patients’ survival. Early dose intensity of treatment is a strong prognostic factor. Improving supportive care and decreasing loss to follow-up are crucial.http://ascopubs.org/doi/10.1200/JGO.19.00172 |
| spellingShingle | Gabrielle C. Bouda Fousseyni Traoré Line Couitchere Marie-Anne Raquin Koffi M. Guedenon Angele Pondy Claude Moreira Mbola Rakotomahefa Mhamed Harif Catherine Patte Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique Journal of Global Oncology |
| title | Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique |
| title_full | Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique |
| title_fullStr | Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique |
| title_full_unstemmed | Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique |
| title_short | Advanced Burkitt Lymphoma in Sub-Saharan Africa Pediatric Units: Results of the Third Prospective Multicenter Study of the Groupe Franco-Africain d’Oncologie Pédiatrique |
| title_sort | advanced burkitt lymphoma in sub saharan africa pediatric units results of the third prospective multicenter study of the groupe franco africain d oncologie pediatrique |
| url | http://ascopubs.org/doi/10.1200/JGO.19.00172 |
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