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首页> 外文期刊>Medical and Pediatric Oncology: The Official Journal of the American Association for Cancer Education >Malawi pilot study of Burkitt lymphoma treatment.
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Malawi pilot study of Burkitt lymphoma treatment.

机译：马拉维Burkitt淋巴瘤治疗的初步研究。

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BACKGROUND: Burkitt lymphoma (BL) accounts for 50% of childhood cancer in Malawi. Lack of resources precludes the use of new successful treatment approaches such as the LMB 89 group B protocol, which cures >80% of children with stage III BL with high dose chemotherapy and matching supportive care. Our objective was to achieve a good cure rate in Murphy stage I-III BL with manageable toxicity in Malawi at a drug cost of <1000 US dollars per patient. PROCEDURE: The intensity and toxicity of the LMB 89 group B protocol was reduced and adapted to Malawi realities. All stages received the same treatment. Children with suspected BL in the period July 1997-November 1999 were subjected to abdominal ultrasound, a tumor biopsy and/or fine needle aspirate (FNA) and bone marrow (BM), cerebrospinal fluid (CSF), and peripheral blood examination. HIV seropositive children were excluded. Endpoints are projected event free survival (EFS) at minimum 1 year, blood and gastro-intestinal tract toxicity, and risk for and severity of infections. RESULTS: Forty-four children were eligible for treatment and analysis. Their median age was 7.2 years, M:F ratio 1.4:1 with 10 stage I, 5 stage II, and 29 stage III patients. Projected Kaplan-Meier EFS for all was 57% (CI 41-73) at 1 year with 90% EFS in stage I and 52% EFS in stage III. The survival curve remained stable at 500 days. Toxicity and delays in appropriate supportive care contributed to ten deaths during treatment. Local recurrent tumor caused five and CNS recurrence one death. Two children died from progressive disease. The incidence of severe (grade 3 and/or 4) hematologic toxicity varied from 13% to 36%, gastro-intestinal toxicity (GIT) from 2% to 17%, and infections from 7% to 41% per chemotherapy module. CONCLUSIONS: It is possible to administer less intense and less costly multiagent chemotherapy to children with BL in a developing society with acceptable EFS rates. Adequate supportive care of the at-times associated severe toxicity must be made available to better the results.
机译：背景：Burkitt淋巴瘤（BL）占马拉维儿童期癌症的50％。缺乏资源无法使用新的成功治疗方法，例如LMB 89 B组方案，该方案可通过高剂量化疗和相配套的支持治疗治愈> 80％的III期BL儿童。我们的目标是在Malphy I-III BL期达到良好的治愈率，并在马拉维实现可控的毒性，每位患者的药物费用低于1000美元。程序：降低了LMB 89 B组方案的强度和毒性，并适应了马拉维的现实。所有阶段均接受相同的治疗。在1997年7月至1999年11月期间怀疑患有BL的儿童接受了腹部超声检查，肿瘤活检和/或细针穿刺（FNA）和骨髓（BM），脑脊液（CSF）以及外周血检查。 HIV血清阳性儿童被排除在外。终点是预计的至少1年无事件生存（EFS），血液和胃肠道毒性以及感染的风险和严重性。结果：44名儿童符合治疗和分析的条件。他们的中位年龄为7.2岁，M：F比为1.4：1，其中I期10例，II期5例和III期29例。预计一年的所有人的Kaplan-Meier EFS为57％（CI 41-73），第一阶段为90％，第三阶段为52％。存活曲线在500天时保持稳定。毒性和适当支持治疗的延迟导致治疗期间10例死亡。局部复发性肿瘤引起5例死亡，中枢神经系统复发1例死亡。两个孩子死于进行性疾病。每个化疗模块的严重（3级和/或4级）血液学毒性发生率从13％到36％不等，胃肠道毒性（GIT）从2％到17％不等，感染率从7％到41％不等。结论：在EFS水平可接受的发展中社会中，可以对BL儿童进行强度较小，成本较低的多药化疗。必须提供及时的与严重毒性相关的充分支持治疗，以改善疗效。

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