Treatment and Characterization of Burkitt Lymphoma

Program: Clinical Studies
Coordinators: Melissa Adde, Ian Magrath,
Other INCTR Participants: Ama Rohatiner, Lorenzo Leoncini, Martine Raphael, KK Naresh
Collaborators: Twalib Ngoma, Dar es Salaam, Tanzania; Nestory Masalu, Mwanza, Tanzania;
Martin Ogwang and Valeria Calbi, Lacor, Uganda;
Muheez Durosinmi, Ile-Ife, Nigeria;
Biobele Brown and Yetunde Aken'Ova, Ibadan, Nigeria;
Jessie Githang'a, Nairobi, Kenya
Branch(es): Brussels, INCTR Challenge Fund
Location: Single Continent
Country(s): Tanzania, Kenya, Uganda, Nigeria
Institutions: Ocean Road Cancer Institute (Tanzania);
Bugando Medical Centre (Tanzania);
Obafemi Awolowo University Teaching Hospitals Complex (Nigeria);
University College Hospital Ibadan (Nigeria);
Kenyatta National Hospital (Kenya);
St Mary's Hospital Lacor (Uganda)
Background Information: Burkitt lymphoma is the most common childhood cancer in equatorial Africa, accounting for some 50% of all pediatric cancer in that region. Most families cannot afford the cost of treatment or even travel to a center capable of providing care. Yet the disease is highly curable, even when resources are limited. This project will be conducted in the form of a clinical trial, such that infrastructure building will result, as well as improved drug procurement and follow up.
Objectives: 1.Improve treatment outcome
2.Train staff in clinical and research management
3.Instill discipline re: data collection; create evidence
4.Improve management of drugs and follow-up
5.Introduce public education to encourage early referral and to demonstrate that cancer can be cured
6.Create a network with District hospitals as part of the care model to improve referral and follow-up
Methods: Undertake treatment in a clinical trial context;
Obtain ethical approval;develop protocol document and CRFs:Train data managers to collect data via CRFs and synchronize with main data base in Brussels; Monitor and query data and make site visits, thus providing on-the-job training; analyze and disseminate results
Progress: The initial results of the study from 4 centers (Ocean Road Cancer Institute, Kenyatta National Hospital, Obafemi Awolowo University Teaching Hospitals Complex and University College Hospital) of the first 356 patients were published in the Br J Haematol in 2012. Overall survival is over 60% at 2 years.
Two new centers joined the study (St Mary's Hospital in 2010 and Bugando Medical Centre in 2011).
Pathology reviewed and centers switching to cutting needle biopsy with immunophenotyping
Linkage with basic research is possible.
To date, over 700 patients have been enrolled in the study. Data was recently re-analyzed to include the newer centers and overall survival is 65% at 2 years.
Future Plans: Educate public and primary HCP; Provide more training and education; Devise new protocol based on present; evaluate other drugs in phase II studies; evaluate value of LDH in triage for treatment;; collect materials for basic research
Duration: Indefinite
Publications: Ngoma T, Adde M, Durosinmi M, Githang'a J, Aken'Ova Y, Kaijage J, Adeodu O, Rajab J, Brown BJ, Leoncini L, Naresh K, Raphael M, Hurwitz M, Scanlan P, Rohatiner A, Venzon D and Magrath I.
Treatment of Burkitt lymphoma in Equatorial Africa Using a simple three drug combination regimen followed by a salvage regimen for patients with persistent or recurrent disease.
British Journal of Haematology, 2012, 158:749-762.
Month: 04
Year: 2015
Last Update: 04/2015
Document: African BL in BJH.pdf (click on "files") below

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