Burkitt lymphoma in South African children: One or two entities?

BackgroundThere is insufficient research into the clinical presentation and outcome after treatment in children with Burkitt’s lymphoma (BL) who are also HIV infected, by comparison with those who are not infected.Patients and methodsThis retrospective study analyzed 15 HIV infected children with BL by comparison with 30 children with BL but not infected with HIV. These children were admitted consecutively in two South African hospitals from 1995 to 2004. The primary localization of the tumor, stage, treatment, relapse and overall survival were the main areas of interest. The distributions of studied variables in the two groups were tested for significance with statistic methods.ResultsThe distribution by age, sex and stage of disease was not significantly different between the two samples. The primary site of tumor was, in both groups, more often in the abdomen than in the head, neck or other areas (53% of HIV positive cases and 80% of HIV negative cases). The chemotherapy protocol was in almost all cases LMB. The mortality ratio was significantly higher in the HIV positive group: 73% (11 out of 15 cases) versus 23% (7/30) – p = 0.002, while the length of follow-up was significantly shorter for the HIV infected children (average 30 months versus 48 months, p = 0.01).ConclusionsThe HIV infection worsens significantly the prognosis of children with BL, in spite of anti-retroviral and cytostatic treatment.