BURKITT'S
LYMPHOMAS IN DEVELOPING COUNTRIES: REPORT OF 450 CASES FROM MOROCCO
Khattab M1, Msefer Alaoui F1
1 Children's Hospital, Rabat, Morocco
Background: Up to 90% of patients with Burkitt's
Lymphomas (BL) can be cured in the developed world. In developing countries
- including Morocco- there are lack of informations about cancer, lack of
medical and nursing expertise, lack of infrastructures and in many
instances lack of medical insurance.
Methods: We receive more than 300 children with
cancers per year, 28% among them have non Hodgkin lymphomas. BL is the
second common childhood malignancy in Morocco.
Results: In this retrospective study, we analysed
450 children with Burkitt's lymphoma diagnosed by cytology-histology
criteria between 1978 and 2000. The age of these children ranged from 2 to
14 years with a median of 5 years. The sex ratio was 3/1. Intra-abdominal
affections were present in 80% of cases. The diagnosis was done by
cytopunction in 75% of cases. According to Murphy staging system, the
stages of our patients were as follow: stage I: 2%; II: 8%; III: 80% and
IV: 10%. Our patients were treated according to the following protocols:
COPAD, LMB 84, LMB89 and GFAOP (Similar to LMB 89 but without doxorubicin).
Complete remission was achieved in 70% of cases and relapses in 4% of
cases. Thirty per cent of cases expired with half of them during the first
week of treatment. Overall survival reached 65% with a median follow up of
9 years.
Conclusion: These data show that the treatment of BL
in Morocco is encouraging. However toxic deaths must be reduced for further
improvement of results.