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Clinical characteristics and outcome of children with Burkitt lymphoma in Uganda according to HIV infection

Authors

  • Jackson Orem MB, ChB,

    1. Uganda Cancer Institute, Mulago Hospital and the Makerere University School of Medicine, Kampala, Uganda
    2. Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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  • Albert Maganda MSc,

    1. Uganda Cancer Institute, Mulago Hospital and the Makerere University School of Medicine, Kampala, Uganda
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  • Edward Katongole Mbidde MB, ChB,

    1. Uganda Cancer Institute, Mulago Hospital and the Makerere University School of Medicine, Kampala, Uganda
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  • Elisabete Weiderpass MD, MSc, PhD

    Corresponding author
    1. Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
    2. Cancer Registry of Norway, Oslo, Norway
    3. Department of Community Medicine, Tromso University, Tromso, Norway
    4. Department of Genetic Epidemiology, Folkhälsan Research Center, Samfundet Folkhälsan, Helsinki, Finland
    • Cancer Registry of Norway, Pb. 5313, Majorstuen, 0304 Oslo, Norway.
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Abstract

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.

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