Cochrane review: Therapeutic interventions for Burkitt's lymphoma in children

Abstract

AbstractBackgroundBurkitt's lymphoma (BL) is a small non‐cleaved cell lymphoma which commonly presents as jaw swellings. Uncertainty remains as to the most effective form of management.ObjectivesTo assess the evidence of any therapeutic strategy in the treatment of BL.Search strategyWe searched MEDLINE (1966 ‐ March 2006), LILACS (1982 ‐ March 2006), EMBASE (1974 ‐ March 2006) and the Cochrane Controlled Trials Register (all years, latest Issue 01/2006) to identify relevant trials. All of these references were accessed in order to identify additional trials in BL.Selection criteriaRandomised controlled trials (RCTs) of any duration were included. We included studies conducted in children with a confirmed diagnosis of BL. Studies were not restricted by geographical location or by language of publication. Any therapeutic intervention was considered. The primary outcome was overall survival.Data collection and analysisTwo reviewers assessed studies for relevance. Studies that met the entry criteria were assessed for study quality. Data were extracted independently and were entered into RevMan 4.2.Main resultsTwelve studies met the entry criteria of the review but data could only be retrieved from ten. Inadequate reporting of study methodology was a common feature of the trials preventing thorough assessment of study quality. We were unable to pool data for any of the outcomes due to the differences between the interventions assessed in the studies. Seven studies aimed to induce remission: Overall survival did not differ significantly between treatment groups in three out of four studies reporting this outcome. Five studies aimed to maintain remission: In two out of three studies reporting survival, it was substantially, but not statistically significantly, different between treatment groups.Authors' conclusionsThis review does not currently provide any strong evidence on the relative effectiveness of interventions to treat Burkitt's lymphoma. The studies that have been conducted to date are small, underpowered and prone to both systematic and random error.Plain language summaryBurkitt's lymphoma is an important cancer particularly in children. It is a fast growing tumour but also very sensitive to chemotherapy. Different regimens have been used to treat this condition with varied success rates. This review was to evaluate these treatments to assess their effectiveness in providing lasting cure. Data could only be reviewed for ten studies but results were difficult to collate due to study and reporting quality, with differing outcome measures, small trial sizes, and each addressing a different question. There is need for further research on treatment options.