Treatment of Paediatric Lymphoblastic Lymphoma in Sub-Saharan Africa: Experience of the Pediatric Oncology Unit of Gabriel Touré Hospital

Abstract

Lymphoblastic lymphomas (LBL) are malignant proliferations of the lymphoid precursors of T cells mainly. LBL accounts for approximately 2% of all non-Hodgkin’s lymphomas in the developed countries. Until the 1970s, diffuse lymphoblastic lymphoma was considered incurable. With intensive multidrug regimens, the majority of patients can now be cured. Event-free survival (EFS) is 70 to 80% in developed countries. In Africa, and particularly in Mali, there are few published studies on the management of this type of cancer in children. The aim of this retrospective study was to evaluate the treatment and outcomes of children with LBL according to the modified EURO-LB 08 protocol at the Pediatric Oncology Unit of the CHU Gabriel Touré of Bamako, Mali. All patients less than 15 years old, with histologic proven LBL treated between October 23, 2009 and April 30, 2016 were included in the study. Ten patients with LBL met the inclusion criteria. LBL accounted for 0.8% of admissions during this period. The age group of 6-11 years represented the majority (n = 7; 70%). The sex ratio was 2.3:1 for girls and boys respectively. Eighty percent of patients had good nutritional status on admission. Polyadenopathy was found in 7 patients (70%). One patient presented with mediastinal mass. Pleural effusion was associated with polyadenopathy in one patient. Stage 3 was predominant (n = 7; 70%). The diagnosis was made by cytology in 80% of patient and histology and immunohistochemistry in 2 patients. Eight patients completed treatment. Grade III neutropenia and anemia were observed in 5 patients. Three patients died from tumor progression during treatment and two patients died from treatment-related toxicity. Three patients were in complete remission at the end of treatment. Early diagnosis and better availability of anticancer drugs may improve the overall survival rate of patients with LBL in Mali.