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Clinical characteristics and outcome of children with Burkitt lymphoma in Uganda according to HIV infection
Author(s) -
Orem Jackson,
Maganda Albert,
Mbidde Edward Katongole,
Weiderpass Elisabete
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21769
Subject(s) - medicine , lymphoma , human immunodeficiency virus (hiv) , chemotherapy , disease , stage (stratigraphy) , pediatrics , surgery , immunology , paleontology , biology
Background Characteristics of children with Burkitt lymphoma (BL) and HIV infection have not been described in Uganda before. Procedure We reviewed records at Uganda Cancer Institute (UCI) for years 1994–2004, to compare clinical features and outcome of BL in children who are HIV positive and negative (HIV+, HIV−). As statistical methods we used Student's t ‐test, Chi‐square and Kaplan–Meier's to compare both groups. Results Of 1,462 records of children retrieved, 228 met the eligibility criteria and were reviewed (158 HIV−, 70 HIV+). There were 139 (61%) males and 89 (39%) females. The mean age was 6.9 years (HIV+ 6.7, HIV− 7.1). One hundred seventy‐one cases (75%) had facial tumor (HIV+ 71.4%, HIV− 76.6%). HIV positive children presented significantly with extrafacial disease (lymphadenopathy 67%, hepatic masses 51%, and thoracic masses 10%). Presentation with advanced stage disease occurred more frequently in HIV positive patients compared to HIV negative patients. Treatment response rates to chemotherapy were similar irrespective of HIV status. However, overall survival was poorer in HIV positive patients with a median survival of 11.79 months ( P ‐value < 0.000, 95% CI 8.65–14.92). Conclusions BL in Uganda presents frequently with facial disease irrespective of HIV status. However HIV+ BL also presents commonly with extra facial sites, mainly lymphadenopathy. There is no difference in response to treatment with chemotherapy, but HIV+ BL patients have poorer survival. There is need for further characterization of BL in Uganda to understand the role of HIV in disease process and outcome. Pediatr. Blood Cancer © 2008 Wiley‐Liss, Inc.