How I treat Burkitt lymphoma in children, adolescents, and young adults in sub-Saharan Africa.

Blood
Satish Gopal, Thomas G Gross

Abstract

Burkitt lymphoma (BL) is the most common pediatric cancer in sub-Saharan Africa (SSA), and also occurs frequently among adolescents and young adults (AYAs), often associated with HIV. Treating BL in SSA poses particular challenges. Although highly effective, high-intensity cytotoxic treatments used in resource-rich settings are usually not feasible, and lower-intensity continuous infusion approaches are impractical. In this article, based on evidence from the region, we review management strategies for SSA focused on diagnosis and use of prephase and definitive treatment. Additionally, potentially better approaches for risk stratification and individualized therapy are elaborated. Compared with historical very low-intensity approaches, the relative safety, feasibility, and outcomes of regimens incorporating anthracyclines and/or high-dose systemic methotrexate for this population are discussed, along with requirements to administer such regimens safely. Finally, research priorities for BL in SSA are outlined including novel therapies, to reduce the unacceptable gap in outcomes for patients in SSA vs high-income countries (HICs). Sustained commitment to incremental advances and innovation, as in cooperative pediatric oncology gr...Continue Reading

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Citations

Oct 23, 2018·Journal of Global Oncology·Satish Gopal
Apr 8, 2020·Leukemia & Lymphoma·Adam S Zayac, Adam J Olszewski
Feb 24, 2019·Blood Advances·Matthew S PainschabSatish Gopal
Mar 23, 2019·Frontiers in Oncology·Jennifer L Crombie, Ann S LaCasce
Nov 11, 2019·Cancer Medicine·Takondwa ZuzeSatish Gopal
Jun 4, 2019·Pediatric Blood & Cancer·Suzanne M McGoldrickCorey Casper
Nov 11, 2020·Blood·Jennifer Crombie, Ann LaCasce
Jun 8, 2021·Current Treatment Options in Oncology·Coen J LapKieron Dunleavy
Aug 7, 2021·JAMA : the Journal of the American Medical Association·Satish Gopal, Norman E Sharpless
Dec 7, 2021·British Journal of Haematology·Maria Luisa MoletiRobin Foà

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