Abstract
Hodgkin lymphoma (HL) is highly curable in high-income countries (HICs), yet many patients around the world do not have access to therapy. In 2012, cancer care was established at a rural district hospital in Rwanda through international collaboration, and a treatment protocol using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) without radiotherapy was implemented. We conducted a retrospective cohort study of all patients with confirmed HL seen at Butaro Hospital from 2012 to 2018 to evaluate quality indicators and clinical outcomes. Eighty-five patients were included (median age, 16.8 years; interquartile range, 11.0-30.5 years). Ten (12%) were HIV positive. Most had B symptoms (70%) and advanced stage (56%) on examination and limited imaging. Of 21 specimens evaluated for Epstein-Barr virus, 14 (67%) were positive. Median time from biopsy to treatment was 6.0 weeks. Of 73 patients who started ABVD, 54 (74%) completed 6 cycles; the leading reasons for discontinuation were treatment abandonment and death. Median dose intensity of ABVD was 92%. Of 77 evaluable patients, 33 (43%) are in clinical remission, 27 (36%) are deceased, and 17 (22%) were lost to follow-up; 3-year survival estimate is 63% (95% CI, 50% to 74%)...Continue Reading
References
Nov 19, 1992·The New England Journal of Medicine·G P CanellosB A Peterson
Jun 26, 2001·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·R DolcettiA Carbone
Oct 29, 2002·Annals of Oncology : Official Journal of the European Society for Medical Oncology·R K ThomasV Diehl
Mar 27, 2004·The New England Journal of Medicine·David A Thorley-Lawson, Andrew Gross
Aug 18, 2009·Annals of Oncology : Official Journal of the European Society for Medical Oncology·W S OwadallyP W M Johnson
Aug 17, 2010·Lancet·Paul FarmerJohn R Seffrin
Mar 9, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lianne WennekesRosella P Hermens
Dec 14, 2011·The New England Journal of Medicine·Ralph M MeyerUNKNOWN Eastern Cooperative Oncology Group
Mar 31, 2012·Blood·Satish GopalRonald T Mitsuyasu
Aug 21, 2013·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Daniela C Stefan
Jan 21, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·George P CanellosVincent T Devita
Jun 18, 2014·Archives of Medical Research·Ju-Han LeeYoung-Sik Kim
Apr 18, 2015·Medicine·Laila M SheriefSafaa H Saleh
Aug 8, 2015·The Lancet Oncology·Sara StulacPaul E Farmer
Nov 19, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lawrence N ShulmanNicola Magrini
Nov 19, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Neo M TapelaLawrence N Shulman
Apr 28, 2016·The New England Journal of Medicine·Satish Gopal
Mar 28, 2017·Journal of Medical Imaging and Radiation Oncology·Daniel E Roos, Hui C Tee
Jan 20, 2016·Journal of Global Oncology·Bogda KoczwaraRoss C Brownson
Jan 20, 2016·Journal of Global Oncology·Tharcisse MpungaDanny A Milner
Aug 2, 2017·The Lancet Oncology·Fidel RubagumyaLawrence N Shulman
Mar 7, 2018·The Lancet Oncology·Bishal GyawaliChristopher M Booth