Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children

Emad Moussa; Asmaa Hamoda; Samah Semary; Marwa Romeih; Randa Amin; Omneya Hassanin

doi:doi:10.11648/j.crj.20190701.14

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Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children

Emad Moussa, Asmaa Hamoda, Samah Semary, Marwa Romeih, Randa Amin, Omneya Hassanin

Published in Cancer Research Journal (Volume 7, Issue 1)

Received: 16 February 2019 Accepted: 25 March 2019 Published: 18 April 2019

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Abstract

Advanced stage Burkiit’s lymphoma (BL) is associated with tumor burden. Toxicities from intensive therapies are significant. The objectives of this study were to analyze the outcome of patients who could not receive induction chemotherapy on time, and were given a 2^nd pre-phase (CVP), and to measure the impact of delay on disease outcome. It is a retrospective non randomized study included pediatric patients, suffering from Burkitt’s Lymphoma over 8 years period in CCHE. The result showed that, four hundred and eight patients were diagnosed as Burkitt’s Lymphoma from July 2007 till October 2015, 286 patients (70.1%) received induction on time as per protocol, while 122 patients (29.9%) were not fit to receive their induction chemotherapy on due time. The delay ranged from 6-45 days. While forty five patients (36.88%) out of the delayed patients received 2^nd CVP, 16 patients (13.1%) showed relapse/progression. OS among delayed patients who received 2^nd CVP versus those who were delayed and were able to receive full induction chemotherapy was (76.1%), (88.7%) respectively. OS in patients who were delayed versus those who were not delayed was (84%), (85.9%) respectively. In conclusion, in critically ill patients delay of chemotherapy in induction phase is important to reduce morbidity and mortality. The delay of chemotherapy has no impact on OS in Burkitt’s lymphoma children. A second pre-phase therapy in our opinion should not be adopted for all critical ill patients who will not tolerate intensive therapy during early phases of treatment, but instead we recommend a recovery from organ toxicity and starting intensive therapy (COPADM) rather than giving 2^nd CVP with careful surveillance of disease progression.

Published in	Cancer Research Journal (Volume 7, Issue 1)
DOI	10.11648/j.crj.20190701.14
Page(s)	25-32
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Burkitt’s Lymphoma, Second Pre-Induction Phase, Chemotherapy Toxicity

References

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APA Style

Emad Moussa, Asmaa Hamoda, Samah Semary, Marwa Romeih, Randa Amin, et al. (2019). Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Research Journal, 7(1), 25-32. https://doi.org/10.11648/j.crj.20190701.14

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ACS Style

Emad Moussa; Asmaa Hamoda; Samah Semary; Marwa Romeih; Randa Amin, et al. Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Res. J. 2019, 7(1), 25-32. doi: 10.11648/j.crj.20190701.14

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AMA Style

Emad Moussa, Asmaa Hamoda, Samah Semary, Marwa Romeih, Randa Amin, et al. Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Res J. 2019;7(1):25-32. doi: 10.11648/j.crj.20190701.14

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@article{10.11648/j.crj.20190701.14,
  author = {Emad Moussa and Asmaa Hamoda and Samah Semary and Marwa Romeih and Randa Amin and Omneya Hassanin},
  title = {Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {1},
  pages = {25-32},
  doi = {10.11648/j.crj.20190701.14},
  url = {https://doi.org/10.11648/j.crj.20190701.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190701.14},
  abstract = {Advanced stage Burkiit’s lymphoma (BL) is associated with tumor burden. Toxicities from intensive therapies are significant. The objectives of this study were to analyze the outcome of patients who could not receive induction chemotherapy on time, and were given a 2nd pre-phase (CVP), and to measure the impact of delay on disease outcome. It is a retrospective non randomized study included pediatric patients, suffering from Burkitt’s Lymphoma over 8 years period in CCHE. The result showed that, four hundred and eight patients were diagnosed as Burkitt’s Lymphoma from July 2007 till October 2015, 286 patients (70.1%) received induction on time as per protocol, while 122 patients (29.9%) were not fit to receive their induction chemotherapy on due time. The delay ranged from 6-45 days. While forty five patients (36.88%) out of the delayed patients received 2nd CVP, 16 patients (13.1%) showed relapse/progression. OS among delayed patients who received 2nd CVP versus those who were delayed and were able to receive full induction chemotherapy was (76.1%), (88.7%) respectively. OS in patients who were delayed versus those who were not delayed was (84%), (85.9%) respectively. In conclusion, in critically ill patients delay of chemotherapy in induction phase is important to reduce morbidity and mortality. The delay of chemotherapy has no impact on OS in Burkitt’s lymphoma children. A second pre-phase therapy in our opinion should not be adopted for all critical ill patients who will not tolerate intensive therapy during early phases of treatment, but instead we recommend a recovery from organ toxicity and starting intensive therapy (COPADM) rather than giving 2nd CVP with careful surveillance of disease progression.},
 year = {2019}
}

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TY - JOUR
T1 - Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children
AU - Emad Moussa
AU - Asmaa Hamoda
AU - Samah Semary
AU - Marwa Romeih
AU - Randa Amin
AU - Omneya Hassanin
Y1 - 2019/04/18
PY - 2019
N1 - https://doi.org/10.11648/j.crj.20190701.14
DO - 10.11648/j.crj.20190701.14
T2 - Cancer Research Journal
JF - Cancer Research Journal
JO - Cancer Research Journal
SP - 25
EP - 32
PB - Science Publishing Group
SN - 2330-8214
UR - https://doi.org/10.11648/j.crj.20190701.14
AB - Advanced stage Burkiit’s lymphoma (BL) is associated with tumor burden. Toxicities from intensive therapies are significant. The objectives of this study were to analyze the outcome of patients who could not receive induction chemotherapy on time, and were given a 2nd pre-phase (CVP), and to measure the impact of delay on disease outcome. It is a retrospective non randomized study included pediatric patients, suffering from Burkitt’s Lymphoma over 8 years period in CCHE. The result showed that, four hundred and eight patients were diagnosed as Burkitt’s Lymphoma from July 2007 till October 2015, 286 patients (70.1%) received induction on time as per protocol, while 122 patients (29.9%) were not fit to receive their induction chemotherapy on due time. The delay ranged from 6-45 days. While forty five patients (36.88%) out of the delayed patients received 2nd CVP, 16 patients (13.1%) showed relapse/progression. OS among delayed patients who received 2nd CVP versus those who were delayed and were able to receive full induction chemotherapy was (76.1%), (88.7%) respectively. OS in patients who were delayed versus those who were not delayed was (84%), (85.9%) respectively. In conclusion, in critically ill patients delay of chemotherapy in induction phase is important to reduce morbidity and mortality. The delay of chemotherapy has no impact on OS in Burkitt’s lymphoma children. A second pre-phase therapy in our opinion should not be adopted for all critical ill patients who will not tolerate intensive therapy during early phases of treatment, but instead we recommend a recovery from organ toxicity and starting intensive therapy (COPADM) rather than giving 2nd CVP with careful surveillance of disease progression.
VL - 7
IS - 1
ER -

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Author Information

Emad Moussa

Department of Clinical Oncology, Menufiya University, Shebeen, Egypt
Asmaa Hamoda

Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
Samah Semary

Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt
Marwa Romeih

Department of Radiodiagnosis, Faculty of Medicine, Helwan University, Helwan, Egypt
Randa Amin

Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt
Omneya Hassanin

Department of Clinical Research, Children Cancer Hospital Egypt, Cairo, Egypt

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APA Style

Emad Moussa, Asmaa Hamoda, Samah Semary, Marwa Romeih, Randa Amin, et al. (2019). Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Research Journal, 7(1), 25-32. https://doi.org/10.11648/j.crj.20190701.14

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ACS Style

Emad Moussa; Asmaa Hamoda; Samah Semary; Marwa Romeih; Randa Amin, et al. Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Res. J. 2019, 7(1), 25-32. doi: 10.11648/j.crj.20190701.14

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AMA Style

Emad Moussa, Asmaa Hamoda, Samah Semary, Marwa Romeih, Randa Amin, et al. Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children. Cancer Res J. 2019;7(1):25-32. doi: 10.11648/j.crj.20190701.14

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@article{10.11648/j.crj.20190701.14,
  author = {Emad Moussa and Asmaa Hamoda and Samah Semary and Marwa Romeih and Randa Amin and Omneya Hassanin},
  title = {Effect of Second Cycle Pre-induction Chemotherapy in Critically Ill Burkitt’s Lymphoma Children},
  journal = {Cancer Research Journal},
  volume = {7},
  number = {1},
  pages = {25-32},
  doi = {10.11648/j.crj.20190701.14},
  url = {https://doi.org/10.11648/j.crj.20190701.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20190701.14},
  abstract = {Advanced stage Burkiit’s lymphoma (BL) is associated with tumor burden. Toxicities from intensive therapies are significant. The objectives of this study were to analyze the outcome of patients who could not receive induction chemotherapy on time, and were given a 2nd pre-phase (CVP), and to measure the impact of delay on disease outcome. It is a retrospective non randomized study included pediatric patients, suffering from Burkitt’s Lymphoma over 8 years period in CCHE. The result showed that, four hundred and eight patients were diagnosed as Burkitt’s Lymphoma from July 2007 till October 2015, 286 patients (70.1%) received induction on time as per protocol, while 122 patients (29.9%) were not fit to receive their induction chemotherapy on due time. The delay ranged from 6-45 days. While forty five patients (36.88%) out of the delayed patients received 2nd CVP, 16 patients (13.1%) showed relapse/progression. OS among delayed patients who received 2nd CVP versus those who were delayed and were able to receive full induction chemotherapy was (76.1%), (88.7%) respectively. OS in patients who were delayed versus those who were not delayed was (84%), (85.9%) respectively. In conclusion, in critically ill patients delay of chemotherapy in induction phase is important to reduce morbidity and mortality. The delay of chemotherapy has no impact on OS in Burkitt’s lymphoma children. A second pre-phase therapy in our opinion should not be adopted for all critical ill patients who will not tolerate intensive therapy during early phases of treatment, but instead we recommend a recovery from organ toxicity and starting intensive therapy (COPADM) rather than giving 2nd CVP with careful surveillance of disease progression.},
 year = {2019}
}

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