{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T19:17:00Z","timestamp":1772565420958,"version":"3.50.1"},"reference-count":32,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Low survival rates among children with Burkitt lymphoma (BL) in low- and middle-income countries (LMICs) are caused by multiple factors, including delays in diagnosis and treatment abandonment. These issues are often linked to the cost of diagnostic tests, treatment, and transportation. This study describes the implementation and effectiveness of a program targeting these issues among children with BL in Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Children with symptoms suggestive of BL between 2017 and 2018 were prospectively enrolled in an intervention program including (1) Diagnosis Delay Intervention by performing flow cytometry and covering its cost and (2) Treatment Abandonment Intervention by reimbursing transportation costs, compensating for some lost family income because of the child's hospital stay, and sending reminder phone calls. A medical record review was conducted to perform a historical comparison of diagnosis delay and treatment outcomes between two cohorts (2010-2016\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      2017-2018) to measure the effectiveness of the program.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Forty-three patients who had a pathologically confirmed diagnosis of BL were enrolled in the intervention program. When comparing the historical cohort (2010-2016; N = 138) and the prospective cohort (2017-2018; N = 43), it was found that after implementing the program, the mean time to diagnosis decreased from 13.57 days to 10.58 days (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .026). Treatment abandonment decreased from 27% to 5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and the event-free survival estimates also showed a significant improvement, increasing from 33% to 63% between the historical and prospective cohorts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .027).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The combination of timely diagnosis and modest financial support for families to complete treatment significantly improved the survival rate of children with BL in our study. This program has the potential to be implemented for children with other cancers and in other LMIC settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00186","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T20:59:09Z","timestamp":1770843549000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Prospective Cohort Study Testing Interventions to Reduce Diagnosis Delay and Treatment Abandonment of Children With Burkitt Lymphoma in Kenya"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8867-5616","authenticated-orcid":true,"given":"Sandra","family":"Langat","sequence":"first","affiliation":[{"name":"Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya"},{"name":"Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Festus","family":"Njuguna","sequence":"additional","affiliation":[{"name":"Moi University, School of Medicine, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Kigen","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha","family":"Kipngetich","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7795-8474","authenticated-orcid":true,"given":"Gilbert","family":"Olbara","sequence":"additional","affiliation":[{"name":"Moi Teaching and Referral Hospital, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Moormann","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School, Worcester, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7424-2921","authenticated-orcid":true,"given":"Gail H.","family":"Vance","sequence":"additional","affiliation":[{"name":"Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Lotodo","sequence":"additional","affiliation":[{"name":"Moi University, School of Medicine, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8252-1333","authenticated-orcid":true,"given":"Boaz","family":"Odwar","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1532-4660","authenticated-orcid":true,"given":"Patrick J.","family":"Loehrer","sequence":"additional","affiliation":[{"name":"Indiana University, School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-8475","authenticated-orcid":true,"given":"Gertjan","family":"Kaspers","sequence":"additional","affiliation":[{"name":"Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4583-8603","authenticated-orcid":true,"given":"Saskia","family":"Mostert","sequence":"additional","affiliation":[{"name":"Unaffiliated Researcher, Heeerhugowaard, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry A.","family":"Vik","sequence":"additional","affiliation":[{"name":"Moi University, School of Medicine, Eldoret, Kenya"},{"name":"Division of Hematology-Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61177-X"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17979"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30576"},{"key":"e_1_3_8_5_2","volume-title":"StatPearls","author":"Graham BS","year":"2022","unstructured":"Graham BS, Lynch DT: Burkitt lymphoma, in StatPearls. 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