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Burkitt lymphoma in South African children: one or two entities?
D Cristina Stefan1, D Stones, R Newton
1Department of Paediatrics and Child Health, Tygerberg Hospital and Stellenbosch University, Tygerberg, Cape Town, South Africa. cs@sun.ac.za
Insights
HIV infection significantly worsens outcomes for children with Burkitt's lymphoma (BL). Survival rates are markedly lower in HIV-positive pediatric BL patients compared to HIV-negative ones, despite treatment.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Limited research exists on Burkitt's lymphoma (BL) in HIV-infected children.
- Understanding clinical presentation and treatment outcomes in this population is crucial.
Purpose of the Study:
- To compare the clinical presentation and outcomes of HIV-infected children with BL to those without HIV infection.
- To identify factors influencing prognosis in pediatric BL.
Main Methods:
- Retrospective analysis of 15 HIV-infected and 30 HIV-negative pediatric BL patients.
- Data collected from two South African hospitals (1995-2004).
- Compared tumor site, stage, treatment, relapse, and survival rates.
Main Results:
- No significant differences in age, sex, or disease stage between groups.
- Abdominal tumors were more common in HIV-negative (80%) than HIV-positive (53%) cases.
- Mortality was significantly higher in HIV-positive children (73%) versus HIV-negative (23%).
Conclusions:
- HIV infection substantially worsens the prognosis for children diagnosed with Burkitt's lymphoma.
- Despite anti-retroviral and cytostatic therapies, HIV-positive pediatric BL patients face poorer outcomes.
Background:
There is insufficient research into the clinical presentation and outcome after treatment in children with Burkitt's lymphoma (BL) who are also HIV infected, by comparison with those who are not infected.
Patients And Methods:
This retrospective study analyzed 15 HIV infected children with BL by comparison with 30 children with BL but not infected with HIV. These children were admitted consecutively in two South African hospitals from 1995 to 2004. The primary localization of the tumor, stage, treatment, relapse and overall survival were the main areas of interest. The distributions of studied variables in the two groups were tested for significance with statistic methods.
Results:
The distribution by age, sex and stage of disease was not significantly different between the two samples. The primary site of tumor was, in both groups, more often in the abdomen than in the head, neck or other areas (53% of HIV positive cases and 80% of HIV negative cases). The chemotherapy protocol was in almost all cases LMB. The mortality ratio was significantly higher in the HIV positive group: 73% (11 out of 15 cases) versus 23% (7/30) -p=0.002, while the length of follow-up was significantly shorter for the HIV infected children (average 30 months versus 48 months, p=0.01).
Conclusions:
The HIV infection worsens significantly the prognosis of children with BL, in spite of anti-retroviral and cytostatic treatment.
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