Intensive chemotherapy for non-localised Burkitt's lymphoma

Between 1982 and 1984, 24 consecutively diagnosed children from Iraq with non-localised Burkitt lymphoma (Murphy stages II, III, and IV) were eligible for treatment with a multi-drug rotating chemotherapy schedule. This schedule was intensive and included early treatment directed at the central nervous system but was of only six months' duration and fairly inexpensive compared with schedules recently advocated for use in the developed world. Some patients had 'debulking' abdominal surgery, but no radiation treatment was used. There were a number of complications related to early treatment, some of them fatal, but of 13 patients entering complete remission 12 are long term survivors who are free of disease and, hopefully, cured. These results represent a substantial improvement over our experience before 1982 (6.9% survival). A similar treatment approach might be adopted by other centres, especially those in developing countries where cancer accounts for a rising proportion of childhood death but whose resources are limited.