Abstract B93: Clinical characteristics, treatment, and outcome of childhood Burkitt's lymphoma in the Uganda Cancer Institute

Abstract

Abstract Introduction: Burkitt's lymphoma (BL), the most common type of childhood cancer in Africa, is a major cause of cancer death among Ugandan children. We conducted a study about trends in the clinical characteristics and outcome of childhood BL over time in the Uganda Cancer Institute (UCI). Subjects and methods: Medical records of individuals with BL aged less than 18 years admitted to the UCI between 1985 and 2005 were reviewed. The study period was divided into the following periods of diagnosis: 1985–1990, 1991–1995, 1996–2000, and 2001–2005. Results: Of the 1,237 medical records of children with BL obtained from UCI patient registers, 1,217 had sufficient recorded information and could be included in our study: 766 (62.94%) boys and 451 (37.60%) girls; the mean age at diagnosis was 6.69 years. There were no significant changes in the proportion of boys and girls diagnosed, nor in the mean age at diagnosis throughout the study period. The most common tumor presentations were facial tumor (77.65%), abdominal disease (69.19%), systemic presentation with generalized lymphadenopathy (42.07%), and hepatic mass (37.80%). Presentation with hepatic mass (p=0.001) and malignant pleocytosis (p<0.001) increased during the study period, whereas other tumor presentations remained similar. Most children presented with stage C (32.12%) or D (26.67%) BL, and there was an increase in the proportion of children presenting with advanced-stage BL during the study period (p=0.005). Overall 89.97% of children in the present study received at least one cycle of chemotherapy, and overall remission was observed in 75.71% of them. The most common symptoms at BL diagnosis were fever (51.03%), anemia (48.73%), and weight loss (48.32%). Significant increases in the proportion of children presenting with fever were observed during the study period (p=0.007), as well as significant changes in the proportion of children presenting with anemia, night sweats (p<0.001 each) and severe infection (p=0.002) between periods of diagnosis. HIV positivity was 3.87%, and no substantial differences in the proportion of children who where HIV positive were revealed in different periods of diagnosis (p=0.205). Five-year mortality was not significantly different during the study period. Conclusions: Mortality was similar in boys and girls, but higher in older children with BL compared to younger ones. Mortality was lower in children who presented with facial tumors compared to other tumor presentations, and higher in those presenting with advanced-stage BL and HIV-positive children. Mortality was substantially lower among those who received chemotherapy. Citation Information: Cancer Prev Res 2011;4(10 Suppl):B93.