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The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non\u2010cross resistant second\u2010line (salvage) therapy, consisting of ifosfamide, mesna, etoposide and cytarabine, when patients failed to achieve a complete response to first\u2010line therapy or relapsed early. Overall survival rates of 67% and 62% were observed at 1 and 2\u00a0years (relapse is rare after 1\u00a0year of remission). Of interest was the small impact of cerebrospinal fluid (<jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content>) and bone marrow involvement on outcome. However, the presence or absence of abdominal involvement clearly defined two prognostic groups. An additional finding was the association between <jats:styled-content style=\"fixed-case\">CSF<\/jats:styled-content> pleocytosis and orbital tumours, suggesting that spread of tumour cells to the central nervous system may sometimes occur via direct involvement of cranial nerves in the orbit. Survival rates may be increased in patients with abdominal involvement by combining first\u2010 and second\u2010line therapy, but verification will require a further clinical study.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2012.09236.x","type":"journal-article","created":{"date-parts":[[2012,7,30]],"date-time":"2012-07-30T07:18:06Z","timestamp":1343632686000},"page":"749-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Treatment of Burkitt lymphoma in equatorial Africa using a simple three\u2010drug combination followed by a salvage regimen for patients with persistent or recurrent disease"],"prefix":"10.1111","volume":"158","author":[{"given":"Twalib","family":"Ngoma","sequence":"first","affiliation":[{"name":"Ocean Road Cancer Institute Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Adde","sequence":"additional","affiliation":[{"name":"International 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