Donations made to INCTR have been used to purchase the chemotherapy drugs from India for four centers. In order to ensure that all patients have access to appropriate supportive care, particularly for the management of febrile neutropenia, INCTR will now include either the provision of drugs or the funds for the purchase of these drugs for the centers.

Case study


Mahija (8 year old) was diagnosed with African Burkitt Lymphoma. At the Ocean Road Cancer Institute in Dar-Es-Salaam, Tanzania she was treated with chemotherapy for 3 weeks. The total cost of her chemotherapy drugs was £120. Three months after her treatment she is living happily and symptom free.

What is Burkitt Lymphoma? Why does it call Burkitt Lymphoma?
In 1965, Dennis Burkitt (1911-1993) - a British surgeon working in central Africa - identified an unusual trype of B-cell lymphoma, which was very common in children he was seeing. This cancer - which later became known as African or 'endemic' Burkitt lymphoma - usually affects the child's jawbone and sometimes the abdomen. Chinldren experience tiredness, sweating at night, unexplained high temperatures, and loss of appetite and weight loss. Despite its dramatic appearance, African Burkitt Lymphome is usually curable if detected early enough and treated with the correct drugs. Left untreated the children die. Burkitt Lymphoma is comparatively rare in the Western world but, although its appearance is less dramatic, the symptoms and outcome, if treated unsuccessfully, are the same. To read more about African Burkitt Lymphoma on our Newsletter Volume 8 Number 2, please click here.

INCTR African Burkitt Lymphoma Programme brief report
The African Burkitt Lymphoma Strategy Group continues to enroll patients on a study entitled, “The Treatment and Characterization of Burkitt Lymphoma (BL) in Africa”. The study was initiated in four centers in three African countries (Nigeria, Kenya, and Tanzania) in 2004. As of the end of 2008, a total of 285 have been enrolled on the study. The objectives of this study were not only to characterize the presentation features of BL and to assess response and survival to treatment, but also to assess the efficacy of a salvage regimen. Patients ranged in age between 2 and 59 years, with a median age of 7 years. The most frequent site of involvement is the jaw followed by the abdomen. All newly diagnosed patients were treated with the First-Line regimen. Patients who failed to respond to First-Line treatment or had early relapses were given Second-Line treatment. Over 74% had a complete response, while about 17% had a partial or no response (PR/NR) o First-Line treatment. An additional 9% could not be evaluated for response due to early deaths from tumor lysis, infection or disease or due to abandonment of treatment. A total of 49 patients received Second-Line treatment (relapses plus PR/NR). The estimated survival for patients who received Second-Line treatment is estimated at 47% at 6 months and 37% at 12 months. Event-free survival (EFS) was 55% at 12 months and 53% at 24 months while overall survival (OS) was 69% at 12 months and 64% at 24 months. When comparing the survival results among the centers, OS at 12 months was higher in Tanzania and Kenya (77% and 73% espectively) when compared to the two Nigerian centers (< 50% at 12 months). The difference is felt to be attributed to the inability of patients in Nigeria to afford antibiotics for treatment of fever/neutropenia and or infections. Upon examination of the data, it was learned that the majority of deaths due to tumor lysis occurred at one institution. Overall, the results are encouraging in that patients who relapsed or who had PR/NR to First-Line treatment could be salvaged with Second Line Treatment – and in some cases late relapses could be salvaged with Repeat First-Line Treatment. Follow up of patients has continued to improve over time. Our goals are to further improve on patient follow up and to prevent preventable deaths.