David McCormick

Endemic Burkitt Lymphoma Pediatric Cases in Malawi

Objectives:
Endemic Burkitt Lymphoma (eBL) is the most common childhood malignancy in Africa, causing approximately 50% of all tumors and 70-80% of all lymphomas. We investigated the clinical and epidemiologic characteristics of eBL at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi.

Methods:
We conducted a retrospective medical record abstraction of all pediatric (<18 years) eBL cases treated at QECH from January 2000-2009. Cases of eBL were confirmed histologically. If histology was not available we relied on the clinical diagnosis. Recurrent eBL cases were excluded. Data were collected on demographic characteristics, disease duration and symptomology, response to treatment, outcome at follow-up, and viral and parasitic coinfections.

Results:
We recorded 475 cases of eBL during 2000-2009; 83.8% had biopsy confirmation. The mean number of annual cases was 41.1 and the mean age of patients was 7.1 ±2.9 years. The majority of patients were male (62.4% ±2.2%) and HIV seroprevalence was significantly higher in eBL cases than the general population (23/459, 5.0% vs. 1.65%; p <0.0001). Most cases (68.2%) presented with advanced disease (Stage III or Stage IV). At discharge, 70.6% of patients had full tumor reduction, 8.6% had partial reduction, 8.4% absconded before treatment was completed, 7.2% died in treatment, and 5.1% were discharged to palliative care.

Conclusions:
Endemic Burkitt Lymphoma is a common pediatric malignancy at QECH. The majority of eBL cases in Malawian children present with advanced disease. Current treatments have a high cure rate, but follow-up data are needed. Further analyses will investigate the comparative efficacy of different treatment regimens.

About David
David is from Knoxville, TN.  He received his bachelor degree from Pomona College double majoring in Molecular Biology and German Studies.  David graduated from the University of Michigan School of Public Health with an MPH in International Health Epidemiology in 2011.
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