They said in some high-income countries, such as the United States and Europe, nine out of every children treated for BL survive beyond five years.
Nurses at the KNH children cancer ward in Nairobi.
Children treated
for a rare but aggressive blood cancer at the Kenyatta National Hospital (KNH) have
one of Africa’s highest survival rates, a five-year analysis indicates.
In many
African countries, only about three to six children treated for the cancer, Burkitt
lymphoma (BL), survive beyond
five years.
However, an
analysis of records of children treated at KNH between January 1, 2016 and
December 31, 2022, indicates that seven out of every ten survived.
Although Burkitt
lymphoma is extremely aggressive and fatal if left untreated, it is often responsive
to the currently recommended intensive chemotherapy regimens, and survival rates in developed countries are high.
A key factor for
the impressivesurvival rate observed at KNH is
the effectiveness of the treatment, researchers who conducted the analysis said.
Their paper,
“Assessment of
Treatment Outcomes and Associated Factors Among Pediatric Patients With Burkitt
Lymphoma at Kenyatta National Hospital”, was published
in the Cancer Reports journal on January 13.
The
researchers, Divya Kumari Toor (United States International University‐Africa),
and pharmacists Dr Amsalu Degu (USIU) and Dr Peter Karimi (University of
Nairobi), said children who fared badly had been diagnosed late and had other
diseases such as diabetes.
“The five‐year
survival rate was 70 per cent in our setting,” they said. “Most patients
had reduced tumour size
and stable disease during the follow-up period.”
In general,
the five-year survival rate is the percentage of people who are alive five
years after receiving a cancer diagnosis. That five-year span is important
because research shows cancer that does not come back (recur) within five years
typically will not come back.
Children
with BL commonly present with large belly tumors, swollen lymph nodes,
tiredness, fever, and other symptoms.
The disease
is treated mainly with chemotherapy and possibly with surgery.
“The
patients were retrospectively monitored from the initial cancer diagnosis until
either death or the last follow‐up appointment visit in the facility. Data
analysis of factors associated with treatment and disease progression‐related
death was carried out,” the researchers said.
At KNH,
survival rates varied based on the stage of cancer and the type of treatment
received.
Divya and
her colleaguesfound that children with advanced disease and those
who received full-dose chemotherapy had a higher risk of death.
“Patients with Stage IV disease who were treated with
full-dose chemotherapy were 19.2 times more likely to die compared to those
with no metastases,” theyreported. This suggests that while full-dose chemotherapy is
a powerful treatment, it also comes with risks.
According to the study, most children with BL in Kenya are
diagnosed at an average age of six years. “The majority of patients were
diagnosed with Stage IV disease, accounting for 46.7 per cent of all cases,” the researchers
reported.
Despite this late diagnosis, many patients responded well to
treatment.
Burkitt lymphoma is the most common type of pediatric cancer
in sub-Saharan Africa. It is linked to the Epstein-Barr virus (EBV) and
malaria, both of which are widespread in the region. The study confirmed that
the endemic type of BL, which is most common in malaria-prone areas, was the
predominant form among the patients at KNH.
The
researchers saidearly diagnosis and access to
the best treatment options is
crucial to good outcome.
They said
in some high-income countries, such as the United States and Europe, nine out of every children treated
for BL survive beyondfiveyears.
The study at KNH suggests that Kenya is making significant
progress in closing this gap.
The researchers
said more needs to be done to improve early diagnosis and treatment in Kenya. “Late-stage
diagnosis remains a challenge, as nearly half of the patients in our study were
already at Stage IV when diagnosed,” they wrote.
The study also pointed out that children with other health
conditions, such as diabetes, had lower survival rates, indicating the need for
more specialized care.
They recommend
better screening programmes,
increased awareness about childhood cancers, and improved access to targeted
therapies.
Nurses at the KNH children cancer ward in Nairobi.