{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:15:31Z","timestamp":1793330131587,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:00:00Z","timestamp":1463529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004477","name":"Universiteit Stellenbosch","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004477","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2016,9,15]]},"abstract":"<jats:p>Discovering how to improve survival and establishing clinical reference points for children diagnosed with endemic Burkitt lymphoma (eBL) in resource\u2010constrained settings has recaptured international attention. Using multivariate analyses, we evaluated 428 children with eBL in Kenya for age, gender, tumor stage, nutritional status, hemoglobin, lactate dehydrogenase (LDH), Epstein\u2010Barr virus (EBV) and <jats:italic>Plasmodium falciparum<\/jats:italic> prior to induction of chemotherapy (cyclophosphamide, vincristine, methotrexate and doxorubicin) to identify predictive and prognostic biomarkers of survival. During this 10 year prospective study period, 22% died in\u2010hospital and 78% completed six\u2010courses of chemotherapy. Of those, 16% relapsed or died later; 31% achieved event\u2010free\u2010survival; and 31% were lost to follow\u2010up; the overall one\u2010year survival was 45%. After adjusting for covariates, low hemoglobin (&lt;8 g\/dL) and high LDH (&gt;400 mU\/ml) were associated with increased risk of death (adjusted Hazard Ratio (aHR)\u2009=\u20091.57 [0.97\u20132.41]) and aHR\u2009=\u20091.84, [0.91\u20133.69], respectively). Anemic children with malaria were 3.55 times more likely to die [1.10\u201311.44] compared to patients without anemia or malarial infection. EBV load did not differ by tumor stage nor was it associated with survival. System\u2010level factors can also contribute to poor outcomes. Children were more likely to die when inadvertently overdosed by more than 115% of the correct dose of cyclophosphamide (<jats:sub>a<\/jats:sub>HR\u2009=\u20091.43 [0.84\u20132.43]) or doxorubicin (<jats:sub>a<\/jats:sub>HR\u2009=\u20091.25, [0.66\u20132.35]), compared with those receiving accurate doses of the respective agent in this setting. This study codifies risk factors associated with poor outcomes for eBL patients in Africa and provides a benchmark by which to assess improvements in survival for new chemotherapeutic approaches.<\/jats:p>","DOI":"10.1002\/ijc.30170","type":"journal-article","created":{"date-parts":[[2016,5,3]],"date-time":"2016-05-03T00:02:17Z","timestamp":1462233737000},"page":"1231-1240","source":"Crossref","is-referenced-by-count":55,"title":["Factors influencing survival among Kenyan children diagnosed with endemic Burkitt lymphoma between 2003 and 2011: A historical cohort study"],"prefix":"10.1002","volume":"139","author":[{"given":"Geoffrey","family":"Buckle","sequence":"first","affiliation":[{"name":"Program in Molecular Medicine University of Massachusetts Medical School Worcester MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Maranda","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences University of Massachusetts 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