Children treated for Burkitt lymphoma (BL), a rare but aggressive blood cancer, at Kenyatta National Hospital (KNH) in Nairobi, have recorded one of Africa’s highest survival rates. An analysis of treatment outcomes from January 1, 2016, to December 31, 2022, revealed that seven out of every ten children survived beyond five years, a significant improvement compared to the survival rates in many African countries, where only three to six out of ten children typically survive this cancer.
Burkitt lymphoma is known for its rapid progression and fatality if left untreated. However, it is also highly responsive to intensive chemotherapy regimens, which has led to better survival rates in developed countries. The success at KNH is largely attributed to the effectiveness of the treatment protocols, which have been adapted to the local context. The survival rate of 70% at KNH is a remarkable achievement, considering that many children in sub-Saharan Africa are diagnosed at advanced stages of the disease.
The researchers found that children diagnosed with BL at KNH presented with large tumors, typically in the abdomen, along with swollen lymph nodes, fever, and fatigue. The treatment for BL primarily involves chemotherapy, sometimes combined with surgery. The study showed that the majority of patients had reduced tumor sizes and stable disease during the follow-up period, despite being diagnosed at later stages. This highlights the importance of timely and effective treatment in improving survival outcomes.
The study also indicated that survival rates varied depending on the stage of cancer at diagnosis and the type of treatment received. Children diagnosed with Stage IV disease, the most advanced stage, had a significantly higher risk of death despite receiving full-dose chemotherapy. The researchers found that children with advanced disease were 19.2 times more likely to die compared to those without metastases. This suggests that while full-dose chemotherapy is a powerful treatment, it also carries risks, especially for children with advanced-stage disease.
Most children with Burkitt lymphoma in Kenya are diagnosed at an average age of six, with nearly half of the patients in the study presenting with Stage IV disease. This late diagnosis poses a significant challenge to treatment outcomes. The study also found that children with additional health conditions, such as diabetes, had lower survival rates, emphasizing the need for specialized care to manage these comorbidities.
Burkitt lymphoma is the most common pediatric cancer in sub-Saharan Africa and is closely linked to the Epstein-Barr virus (EBV) and malaria, both of which are endemic in the region. The study confirmed that the endemic form of BL, associated with malaria, was the predominant type among the children treated at KNH. This underscores the need for more targeted interventions in malaria-prone areas.
While the survival rates at KNH are promising, the study highlights that there is still much to be done to improve early diagnosis and treatment in Kenya. Nearly half of the patients in the study were diagnosed at Stage IV, indicating a need for better screening programs and increased awareness of childhood cancers. The researchers recommend the implementation of more comprehensive screening initiatives, greater public awareness of childhood cancers, and improved access to targeted therapies to enhance survival rates further.
In conclusion, the study at KNH offers a hopeful outlook for children diagnosed with Burkitt lymphoma in Kenya, showing that with timely diagnosis and appropriate treatment, survival rates can be significantly improved. However, more efforts are needed to address the challenges of late-stage diagnosis and comorbidities to ensure even better outcomes in the future.
