{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T21:14:50Z","timestamp":1783372490637,"version":"3.54.6"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T00:00:00Z","timestamp":1559520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>\u201cEndemic\u201d Burkitt lymphoma (BL) is a common childhood cancer in Africa. Social and treatment factors may contribute to poor survival. With the aim of improving BL outcomes in Uganda, we undertook a comprehensive project (BL Project) that provided diagnostic support, access to standard chemotherapy, nutritional evaluations, and case management. We evaluated survival of children with BL in the context of the project.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Patients followed by the BL Project who consented to research were enrolled in this study. Children with a pathology diagnosis consistent with BL were eligible. Data were collected prospectively. First\u2010line chemotherapy generally consisted of six cycles of cyclophosphamide, vincristine, low\u2010dose methotrexate (COM). We used Kaplan\u2013Meier and Cox regression analyses to evaluate factors associated with overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between July 2012 and June 2017, 341 patients with suspected BL presented to the BL Project. One hundred eighty patients with a pathology\u2010based diagnosis were included in this study. The median age was seven years (interquartile range, 5\u20139), 74% lived \u2265100\u00a0km from the Uganda Cancer Institute, 61% had late\u2010stage disease, 84% had ECOG performance status\u00a0&lt;\u00a03, 63% reported B\u2010symptoms, and 22% showed neurologic symptoms. Fewer than 10% abandoned therapy. The four\u2010year OS rate was 44% (95% CI, 36%\u201353%). In a multivariate model, ECOG status was significantly associated with mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The BL Project reduced effects of lacking supportive care and oncology resources, and allowed patients from Uganda to receive curative intent therapy with minimal loss to follow\u2010up. Nonetheless, OS remains unacceptably low. Improved therapeutic approaches to endemic BL are urgently needed in Africa.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.27813","type":"journal-article","created":{"date-parts":[[2019,6,3]],"date-time":"2019-06-03T11:36:07Z","timestamp":1559561767000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Survival of children with endemic Burkitt lymphoma in a prospective clinical care project in Uganda"],"prefix":"10.1002","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-5741","authenticated-orcid":false,"given":"Suzanne M.","family":"McGoldrick","sequence":"first","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innocent","family":"Mutyaba","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott V.","family":"Adams","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Larsen","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Krantz","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constance","family":"Namirembe","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mooka","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Nabakooza","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Ndagire","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin","family":"Mubiru","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Nabwana","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Nankinga","sequence":"additional","affiliation":[{"name":"Hutchinson Centre Research Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gerdts","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristin","family":"Gordon\u2010Maclean","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadhil","family":"Geriga","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abrahams","family":"Omoding","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Sessle","sequence":"additional","affiliation":[{"name":"PATH  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Kambugu","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas S.","family":"Uldrick","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Orem","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey","family":"Casper","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Global Health Infectious Disease Research Institute and the University of Washington  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1179\/2046905511Y.0000000016"},{"key":"e_1_2_10_3_1","volume-title":"International Incidence of Childhood Cancer","author":"Steliarova\u2010Foucher E","year":"2017"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09027.x"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.09013.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23800"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197707142970202"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(79)92627-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18004619704"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30170"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13986"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(12)70598-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21452"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10322"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20254"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10190"},{"issue":"15","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"10507","DOI":"10.1200\/JCO.2016.34.15_suppl.10507","article-title":"Results of the randomized intergroup trial Inter\u2010B\u2010NHL Ritux 2010 for children and adolescents with high\u2010risk B\u2010cell non\u2010Hodgkin lymphoma (B\u2010NHL) and mature acute leukemia (B\u2010AL): evaluation of rituximab (R) efficacy in addition to standard LMB chemotherapy (CT) regimen","volume":"34","author":"Minard\u2010Colin V","year":"2016","journal-title":"J Clin Oncol"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e3282f424b0"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-036665"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.6376"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature11378"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-566778"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-036673"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32006"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09026.x"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14440"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13986"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-04-844472"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4158"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.7314\/APJCP.2013.14.5.3363"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880018.2011.644881"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24407"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26790"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26945"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.27813","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.27813","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.27813","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T03:07:38Z","timestamp":1694315258000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.27813"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,3]]},"references-count":33,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1002\/pbc.27813"],"URL":"https:\/\/doi.org\/10.1002\/pbc.27813","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,3]]},"assertion":[{"value":"2018-07-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e27813"}}