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Mishra A, Mishra A, Taylor MA, Sharma D, Kubesh M. Poor disease-specific survival in Black pediatric patients diagnosed with Burkitt lymphoma: An analysis of the Surveillance, Epidemiology, and End Results database. Pediatr Blood Cancer 2024; 71:e31204. [PMID: 39010654 DOI: 10.1002/pbc.31204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/17/2024]
Affiliation(s)
- Anjali Mishra
- School of Medicine, Creighton University, Omaha, Nebraska, USA
| | - Avisya Mishra
- School of Medicine, St. George's University, St. George's, Grenada
| | - Mitchell A Taylor
- School of Medicine, Creighton University, Omaha, Nebraska, USA
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Divya Sharma
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Molly Kubesh
- Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri, USA
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2
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Winke C, Moore B, Gelman J, Paul S, Rouster A, Guido A. A case of Burkitt Lymphoma discovered by digital rectal exam. JPGN REPORTS 2024; 5:363-366. [PMID: 39149199 PMCID: PMC11322034 DOI: 10.1002/jpr3.12077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 08/17/2024]
Abstract
Burkitt Lymphoma (BL) is an aggressive B-cell lymphoma predominantly encountered in pediatrics. Sporadic type typically involves the abdomen and/or pelvis. We present an 8-year-old Caucasian male with vomiting, weight loss, fatigue, and abdominal pain. An abdominal X-ray was unremarkable without any acute findings. Pediatric gastroenterology was consulted and recommended esophagogastroduodenoscopy and colonoscopy. A digital rectal exam (DRE) was performed, and a firm lesion was palpated. The colonoscopy was normal. Subsequent magnetic resonance imaging and computed tomography scans revealed a lesion in the left lower quadrant with mass-like processes involving the porta hepatis and encasing the left distal ureter. Tissue biopsy confirmed BL. The patient completed chemotherapy and achieved remission. This case highlights DRE as a basic physical exam skill in the evaluation of patients with nonspecific gastrointestinal symptoms.
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Affiliation(s)
- Colin Winke
- Department of Pediatrics, Division of Pediatric Gastroenterology and HepatologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
| | - Brandon Moore
- Department of Pediatrics, Division of Pediatric Gastroenterology and HepatologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
| | - Jacob Gelman
- Department of Pediatrics, Division of Pediatric Gastroenterology and HepatologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
| | - Stephan Paul
- Department of Pediatrics, Section of Hematology/OncologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
| | - Audra Rouster
- Department of Pediatrics, Division of Pediatric Gastroenterology and HepatologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
| | - Amy Guido
- Department of Pediatrics, Division of Pediatric Gastroenterology and HepatologyWest Virginia University School of MedicineMorgantownWest VirginiaUSA
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Siddiqui SH, Thakral B, Aakash F, Ok CY, Tang Z, Medeiros LJ. From the archives of MD Anderson Cancer Center: Sporadic Burkitt lymphoma with a complex karyotype and SOX11 expression. Ann Diagn Pathol 2023; 66:152182. [PMID: 37543028 DOI: 10.1016/j.anndiagpath.2023.152182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 07/20/2023] [Indexed: 08/07/2023]
Abstract
Burkitt lymphoma (BL) is a mature B-cell neoplasm arising from germinal center B-cells. There are three epidemiological variants of which the sporadic variant is most prevalent in developed countries representing 1-2 % of all lymphomas in adults. Patients usually present with bulky abdominal masses and ~ 30 % have bone marrow involvement. BL is characterized by a germinal center B-cell immunophenotype and usually has a simple karyotype. Here we report an unusual case of sporadic BL in a 44-year-old man and we use this case to review sporadic BL in adults. The patient presented with a cecal mass and bone marrow involvement. Biopsy of the cecal mass and bone marrow evaluation showed infiltration by intermediate-size lymphoma cells positive for monotypic kappa, CD10, CD19, CD20, CD22, CD38 bright, CD43, CD45, Bcl6 and ROR1, and negative for CD11c, CD23, CD30, CD44, CD200 and Bcl2. As expected, the lymphoma cells were strongly positive for MYC and Ki-67 showed a proliferation rate of nearly 100 %, but the cells were also positive for SOX11 and cytoplasmic LEF1. Conventional chromosomal analysis revealed t(8;14) as part of a complex karyotype. Based on our literature review, and is shown in this case, sporadic BL in adults shows some differences with the classic description of BL in children. We also discuss the differential diagnosis of BL.
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Affiliation(s)
- Saima Haleem Siddiqui
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Fnu Aakash
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Chi Young Ok
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Zhenya Tang
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
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4
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Mburu W, Devesa SS, Check D, Shiels MS, Mbulaiteye SM. Incidence of Burkitt lymphoma in the United States during 2000 to 2019. Int J Cancer 2023; 153:1182-1191. [PMID: 37278097 PMCID: PMC10524887 DOI: 10.1002/ijc.34618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
Burkitt lymphoma (BL) is an aggressive B-cell lymphoma that occurs worldwide. A study of BL in the US National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program during 1973 to 2005 (n = 3043) revealed three age-specific incidence peaks of BL and rates that were rising. We studied BL cases diagnosed in SEER 22 during 2000 to 2019 (n = 11 626) to investigate age-specific BL incidence rates and temporal trends. The age-standardized BL incidence rate was 3.96/million person-years, with a 2.85:1 male-to-female ratio. The BL rate among both Hispanic and White individuals was higher than in Black individuals (4.52, 4.12 vs 3.14). Age-specific BL rates showed peaks during pediatric, adult and elderly years in males and pediatric and elderly peaks in females. Based on 4524 BL cases with HIV status (SEER 13), only one peak in adult males (45 years) was observed. Overall age-standardized BL incidence rates rose 1.2%/year (not significant) up to 2009 then fell significantly by 2.4%/year thereafter. Temporal trends in BL rates during 2000 to 2019 varied with age group as pediatric BL rates rose 1.1%/year, while elderly BL rates fell 1.7%/year and adult BL rates rose 3.4%/year until 2007 before falling 3.1%/year thereafter. Overall survival from BL was 64% at 2 years, being highest in pediatric patients and lowest in Black and elderly individuals vs other subgroups. Survival improved by 20% between 2000 and 2019. Our data suggest that BL age-specific incidence rates are multimodal and that overall BL rates rose up to 2009 and then fell, suggesting changes in etiological factors or diagnosis.
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Affiliation(s)
| | - Susan S. Devesa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - David Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Alomar K, Orabi A, Qatleesh S, Saleh IEA, Hamdan O, Ahmad F. A rare case of Burkitt's lymphoma of the duodenal bulb in a 9 year-old child - A case report and review of the literature. Int J Surg Case Rep 2023; 109:108525. [PMID: 37499347 PMCID: PMC10413052 DOI: 10.1016/j.ijscr.2023.108525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The presence of Burkitt's lymphoma in the duodenum is very rare, as this lymphoma is most commonly found at the end of the ileum, as it contains a high proportion of lymphoid tissue, spreads rapidly, and is aggressive. Primary diagnosis by histological examination. It gives a starry sky view with positive for tumor markers. CASE PRESENTATION We reported a child suffering from recurrent vomiting with weight loss, and a radiological examination revealed the presence of a mass in the duodenum causing obstruction there. Upper gastrointestinal endoscopy was performed, and biopsies were obtained for histologic examination. Burkitt's lymphoma was then diagnosed, palliative surgery was performed, and appropriate chemotherapy was subsequently applied. CLINICAL DISCUSSION Burkitt's lymphoma is rare in the duodenum. However, it should be considered in the differential diagnosis of duodenal problems to allow early diagnosis and treatment. CONCLUSION Burkitt's lymphoma is diagnosed by histologic examination and is very aggressive. However, it is highly responsive to chemotherapy in the absence of poor prognostic factors.
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Affiliation(s)
- Khaled Alomar
- Damascus University - University pediatrics' Hospital, Syria.
| | - Alaa Orabi
- Damascus University - University pediatrics' Hospital, Syria
| | - Safaa Qatleesh
- Damascus University - Al Assad University Hospital, Syria
| | | | - Othman Hamdan
- Damascus University - University pediatrics' Hospital, Syria
| | - Fariz Ahmad
- Damascus University - Al Assad University Hospital, Syria
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Lu X, Liu Y, Liu R, Liu J, Yan X, Qian L. Comparison of chemotherapy regimens plus rituximab in adult Burkitt lymphoma: A single-arm meta-analysis. Front Oncol 2022; 12:1063689. [PMID: 36620579 PMCID: PMC9816660 DOI: 10.3389/fonc.2022.1063689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Background and aim Given the paucity of evidence-based treatment recommendations, the most appropriate first-line regimen for adult Burkitt lymphoma is currently undefined. We aimed to identify the optimal treatment regimen containing rituximab for adult Burkitt lymphoma patients. Methods The PubMed, Embase, Web of Science, and Cochrane databases were searched in December 2021 (10). We included all studies for the treatment of Burkitt lymphoma including rituximab. We excluded studies of patients aged ≤14 years old and those with sample numbers ≤10 patients. Random-effects models were used to compare different chemotherapy regimens regarding estimated 2-year overall survival (OS) rate, 2-year progression-free survival (PFS) rate, and overall response rate (ORR). Results A total of 17 studies were included in this meta-analysis and divided into four groups: CODOX-M/IVAC, DA-EPOCH, GMALL-B-ALL/NHL2002, and Hyper-CVAD. DA-EPOCH was associated with a significantly higher 2-year OS rate [0.95, 95% confidence interval (CI) 0.86-1.00]. There was no significant difference in the 2-year PFS rates (0.81, 95% CI 0.76-0.85) and ORR (0.90, 95% CI 0.87-0.94) between these four treatment regimens. Conclusions The meta-analysis indicates that DA-EPOCH could be more effective in providing curative treatment for adult Burkitt lymphoma patients, especially without CNS and BM involvement considering OS time. Due to the types of studies and the limited number of included studies, bias should be acknowledged and a randomized controlled trial (RCT) needs to be performed to further identify the optimal treatment regimen for such patients.
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Affiliation(s)
- Xiaoxuan Lu
- Senior Department of Hematology, The Fifth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China
| | - Yu Liu
- Senior Department of Hematology, The Fifth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China
| | - Ruyu Liu
- Senior Department of Hematology, The Fifth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China
| | - Jiaxin Liu
- Department of Hematology, The Sixth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China
| | - Xiaojing Yan
- Department of Hematology, The First Affiliated Hospital of China Medical University, Shenyang, China,*Correspondence: Xiaojing Yan, ; Liren Qian,
| | - Liren Qian
- Senior Department of Hematology, The Fifth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China,Department of Hematology, The Sixth Medical Center of People's Liberation Army (PLA), General Hospital, Beijing, China,*Correspondence: Xiaojing Yan, ; Liren Qian,
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Soyland DJ, Thanel PF, Sievers ME, Wagner K, Vuong SM. Primary epidural sporadic Burkitt lymphoma in a 3-year-old: Case report and literature review. Surg Neurol Int 2022; 13:106. [PMID: 35399880 PMCID: PMC8986637 DOI: 10.25259/sni_1172_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Burkitt lymphoma (BL) is a common tumor of childhood that usually arises in the abdomen or pelvis in its sporadic form. In a minority of cases, BL can present with CNS involvement, usually as a secondary site. Rarely, BL can arise primarily in the epidural space and present with back pain, or less commonly, acute myelopathy. This presentation is a surgical emergency and requires vigilant management. Case Description: We describe a case of pediatric BL arising primarily within the epidural space and presenting with progressive difficulty walking in a 3-year-old boy. Progression to complete inability to walk, absent lower extremity deep tendon reflexes, and new urinary incontinence prompted MRI of the spine, which showed a lesion extending from T5 to T10 and wrapping around the anterior and posterior portions of the spine with evidence of spinal cord compression. The patient underwent decompressive laminectomies from T5 to T10 and partial debulking of the posterior portions of the tumor. Microscopic examination showed a prominent “starry sky” pattern with abundant mitotic figures. Immunohistochemistry confirmed the diagnosis of BL. The patient is 10 months post-op and continues to undergo chemotherapy with partial neurologic improvement. He was free of recurrence 10 months post-operative. Conclusion: This appears to be the youngest described patient presenting with acute myelopathy in primary paraspinal BL. Management should include surgical decompression of the spinal cord followed by one of the various described chemotherapeutic regimens. Preoperative staging and neurologic function correlate with prognosis.
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Affiliation(s)
- Dallas J. Soyland
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Paul F. Thanel
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Meaghan E. Sievers
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Kayelyn Wagner
- Department of Pediatric Oncology, Sanford School of Medicine, Sioux Falls, South Dakota, United States
| | - Shawn M. Vuong
- Department of Neurosurgery, Sanford School of Medicine, Sioux Falls, South Dakota, United States
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Ismail S, Abdulrahman SA, Muhammad I, Ghanem A, Daoud A, Alshehabi Z. Primary intestinal Burkitt's lymphoma in a Syrian child with a challenging initial presentation: A case report and literature review. Ann Med Surg (Lond) 2022; 75:103453. [PMID: 35386777 PMCID: PMC8977899 DOI: 10.1016/j.amsu.2022.103453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/23/2022] [Accepted: 02/28/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sawsan Ismail
- Department of Pathology, Faculty of Medicine, Cancer Research Center, Tishreen University, Lattakia, Syria
- Corresponding author.
| | | | - Ibrahim Muhammad
- Faculty of Medicine, Cancer Research Center, Tishreen University, Lattakia, Syria
| | - Abdulmoniem Ghanem
- Department of Pediatrics, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Ali Daoud
- Department of Pediatrics, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Zuheir Alshehabi
- Department of Pathology, Faculty of Medicine, Cancer Research Center, Tishreen University, Lattakia, Syria
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Schmiester M, Tranter E, Lorusso A, Blaschke F, Geisel D, Bullinger L, Damm F, Na IK. Acute left ventricular insufficiency in a Burkitt Lymphoma patient with myocardial involvement and extensive local tumor cell lysis: a case report. BMC Cardiovasc Disord 2022; 22:31. [PMID: 35120455 PMCID: PMC8815241 DOI: 10.1186/s12872-022-02480-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/27/2022] [Indexed: 11/30/2022] Open
Abstract
Background Burkitt lymphoma (BL) is a rare disease with the sporadic variant accounting for less than 1% of adult non-Hodgkin lymphomas. BL usually presents with an abdominal bulk, but extranodal disease affecting the bone marrow and central nervous system is common. Cardiac manifestations, however, are exceedingly rare, with less than 30 cases reported in the literature. Case presentation We report on a 54-year-old male patient with a six week-long history of paranasal sinus swelling, fatigue and dyspnea on exertion. Stage IV sporadic BL with extensive lymphonodal and cardiovascular involvement was diagnosed. Manifestations included supra- and infradiaphragmatic lymphadenopathy as well as infiltration of the aortic root, the pericardium, the right atrium and the right ventricle. EBV-reactivation was detected, which is uncommon in the sporadic subtype. After initial full-dose chemotherapy with very good BL control, the patient developed acute, but fully reversible cardiac insufficiency. Myocardial lymphoma involvement receded completely during the following two therapy cycles, while cardiac function periodically deteriorated shortly after chemotherapy administration and quickly recovered thereafter. Interestingly, the decline in cardiac function lessened with decreasing myocardial lymphoma manifestation. Once the cardiovascular BL infiltration was resolved, cardiac function remained stable throughout further treatment. Following seven cycles of chemotherapy and mediastinal radiation, the patient is now in continued complete remission. Conclusions Although rare, cardiac involvement in BL can quickly become life-threatening due to rapid lymphoma doubling time and should therefore be considered at initial diagnosis. This case suggests an association between myocardial infiltration, chemotherapy associated tumor cell lysis and transient deterioration of cardiac function until the damage caused by the underlying lymphoma could be restored. While additional studies are needed to further elucidate the mechanisms of acute cardiac insufficiency due to lymphoma lysis in the infiltrated structures, prompt BL control and full recovery of the patient supports courageous treatment start despite extensive cardiovascular involvement.
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Affiliation(s)
- Maren Schmiester
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Eva Tranter
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alessandro Lorusso
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Blaschke
- Department of Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Geisel
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Lars Bullinger
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frederik Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Il-Kang Na
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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Chamberlain G, Coltin H, Klaassen RJ, Story E, Abbott LS. Successful treatment of pediatric primary hepatic Burkitt lymphoma using rituximab: A case report. Pediatr Blood Cancer 2021; 68:e29259. [PMID: 34357676 DOI: 10.1002/pbc.29259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/14/2021] [Indexed: 11/09/2022]
Affiliation(s)
| | - Hallie Coltin
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Hospital for Sick Children, Toronto, Ontario, Canada
| | - Robert J Klaassen
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Eden Story
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Lesleigh S Abbott
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
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11
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Sporadic Burkitt Lymphoma Presenting with Middle Cranial Fossa Masses with Sphenoid Bony Invasion and Acute Pancreatitis in a Child. Case Rep Oncol Med 2021; 2021:6610666. [PMID: 34567815 PMCID: PMC8457982 DOI: 10.1155/2021/6610666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/13/2021] [Indexed: 11/18/2022] Open
Abstract
Acute pancreatitis in children is usually due to infection, trauma, or anatomical abnormalities and is rarely due to obstruction from malignancy. Sporadic Burkitt lymphoma (BL) is an aggressive non-Hodgkin B-cell lymphoma that usually involves the bowel or pelvis, with isolated cases presenting as acute pancreatitis. We report a case of BL in a 12-year-old male presenting as acute pancreatitis with obstructive jaundice and a right middle cranial fossa mass invading the sphenoid bone. The common bile duct in this case was dilated to 21 mm in diameter on abdominal ultrasound and to 26 mm on magnetic resonance cholangiopancreatography (MRCP), significantly greater than any value reported in the literature for BL. Given the rapidly progressing nature of BL, we emphasize the importance of recognizing heterogeneous presentations of this disease to improve patient survival. We also conclude that it is important to consider malignancy in a child with acute pancreatitis, particularly in the presence of obstructive jaundice or multisystem involvement. Other Presentations. This case report has no prior publications apart from the abstract being accepted to the 2020 SIOP (International Society of Pediatric Oncology) meeting and 2020 ASPHO conference (canceled due to the COVID-19 pandemic) and subsequently published as an abstract only in Pediatric Blood and Cancer. We have also presented the abstract as a poster presentation at our institution's (NYU Langone Hospital—Long Island, previously known as NYU Winthrop) annual research day conference in 2020.
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12
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Ahsanuddin S, Cadwell JB, Sangal NR, Grube JG, Fang CH, Baredes S, Eloy JA. Survival Predictors of Head and Neck Burkitt's Lymphoma: An Analysis of the SEER Database. Otolaryngol Head Neck Surg 2021; 167:79-88. [PMID: 34491862 DOI: 10.1177/01945998211041533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze population-level data for Burkitt's lymphoma of the head and neck. STUDY DESIGN Retrospective study of a national cancer database. SETTING Academic medical center. METHODS The SEER database (Surveillance, Epidemiology, and End Results) identified all patients with primary Burkitt's lymphoma of the head and neck from 1975 to 2015. Demographic, clinicopathologic, and treatment characteristics were analyzed. Multivariable Cox regressions analyzed factors associated with survival while controlling for baseline differences. RESULTS A total of 920 patients with a mean (SD) age of 37.6 years (25.0) were identified. A majority of patients were White (82.8%) and male (72.3%). The most primary common sites included the lymph nodes (61.3%), pharynx (17.7%), and nasal cavity/paranasal sinuses (5.2%). The majority of patients received chemotherapy (90.5%), while fewer underwent surgery (42.1%) or radiotherapy (12.8%). Choice of treatment differed significantly among patients of different ages, year of diagnosis, primary site, nodal status, and Ann Arbor stage. Overall 10-year survival was 67.8%. On multivariable Cox regression, patients with older age (hazard ratio [HR], 1.05 per year; P < .001) and higher stage at presentation had increased risk of mortality (P < .001). Furthermore, cases diagnosed between 2006 and 2015 (HR, 0.35; P < .001) and 1996 and 2005 (HR, 0.53; P = .001) had lower mortality when compared with those diagnosed between 1975 and 1995. Treatment including surgery and chemotherapy tended to have the best survival (P < .001). CONCLUSION Burkitt's lymphoma of the head and neck diagnosed in more recent years has had improved survival. Factors significantly associated with survival include age, Ann Arbor stage, and treatment regimen. Treatment including surgery and chemotherapy was associated with the highest survival.
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Affiliation(s)
- Salma Ahsanuddin
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joshua B Cadwell
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Neel R Sangal
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jordon G Grube
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, USA
| | - Christina H Fang
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center-RWJBarnabas Health, Livingston, New Jersey, USA
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13
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Rochford R. Reframing Burkitt lymphoma: virology not epidemiology defines clinical variants. ANNALS OF LYMPHOMA 2021; 5:22. [PMID: 34888589 PMCID: PMC8654190 DOI: 10.21037/aol-21-18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 1964, Epstein-Barr virus (EBV) was identified in a biopsy from a patient with Burkitt lymphoma (BL) launching a new field of study into this ubiquitous human virus. Almost 60 years later, insights into the role of EBV in lymphomagenesis are still emerging. While all BL carry the hallmark c-myc translocation, the epidemiologic classification of BL (e.g., endemic, sporadic or immunodeficiency-associated) has traditionally been used to define BL clinical variants. However, recent studies using molecular methods to characterize the transcriptional and genetic landscape of BL have identified several unique features are observed that distinguish EBV+ BL including a high level of activation induced deaminase mutation load, evidence of antigen selection in the B cell receptor, and a decreased mutation frequency of TCF3/ID3, all found predominantly in EBV+ compared to EBV- BL. In this review, the focus will be on summarizing recent studies that have done in depth characterization of genetic and transcriptional profiles of BL, describing the differences and similarities of EBV+ and EBV- BL, and what they reveal about the etiology of BL. The new studies put forth a compelling argument that the association with EBV should be the defining etiologic feature of clinical variants of BL. This reframing of BL has important implications for therapeutic interventions for BL that distinguish the EBV+ from the EBV- lymphomas.
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Affiliation(s)
- Rosemary Rochford
- Department of Immunology and Microbiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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14
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Goel AN, Filimonov A, Teruya-Feldstein J, Salib C, Rousso JJ, Hackett AM, Rothschild MA, Wanna GB. Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report. Am J Otolaryngol 2021; 42:102977. [PMID: 33636684 DOI: 10.1016/j.amjoto.2021.102977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/13/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe a case of Burkitt lymphoma (BL) in a child manifesting with acute airway obstruction. To review available literature on the clinical features and characteristic presentation of this disease. METHODS Case report with literature review. RESULTS We present the case of an 8-year-old boy with nasopharyngeal BL manifesting initially as sore throat, nasal congestion, and snoring that progressed to dyspnea and, ultimately, acute airway obstruction requiring emergent tracheostomy. The child was treated with intensive chemotherapy and achieved complete response. CONCLUSION This case highlights the importance of maintaining high clinical suspicion when evaluating common otolaryngologic symptoms and emphasizes the potential for Burkitt lymphoma to cause rapid patient deterioration.
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Affiliation(s)
- Alexander N Goel
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA.
| | - Andrey Filimonov
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | | | - Christian Salib
- Department of Pathology, Icahn School of Medicine at Mount Sinai, NY, New York, USA
| | - Joseph J Rousso
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - Alyssa M Hackett
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - Michael A Rothschild
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, USA; Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, NY, New York, USA
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15
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Mason EF, Kovach AE. Update on Pediatric and Young Adult Mature Lymphomas. Clin Lab Med 2021; 41:359-387. [PMID: 34304770 DOI: 10.1016/j.cll.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
After acute leukemia and brain and central nervous system tumors, mature lymphomas represent the third most common cancer in pediatric patients. Non-Hodgkin lymphoma accounts for approximately 60% of lymphoma diagnoses in children, with the remainder representing Hodgkin lymphoma. Among non-Hodgkin lymphomas in pediatric patients, aggressive lymphomas, such as Burkitt lymphoma, diffuse large B-cell lymphoma, and anaplastic large cell lymphoma, predominate. This article summarizes the epidemiologic, histopathologic, and molecular features of selected mature systemic B-cell and T-cell lymphomas encountered in this age group.
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Affiliation(s)
- Emily F Mason
- Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, 4603A TVC, Nashville, TN 37232-5310, USA.
| | - Alexandra E Kovach
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop #32, Los Angeles, CA 90027, USA
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16
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Xiao Z, Mo Y, Long W, Li R, Li X, Wei Y, Fan W, Zhang X. Value of baseline and end of chemotherapy 18F-FDG PET/CT in pediatric patients with Burkitt lymphoma. Leuk Lymphoma 2021; 62:2873-2881. [PMID: 34165390 DOI: 10.1080/10428194.2021.1941933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to analyze whether the baseline metabolic parameters of 18F-FDG PET/CT in pediatric patients with Burkitt lymphoma (BL) can predict treatment response and prognosis. We retrospectively analyzed 68 pediatric patients with BL who underwent PET/CT before treatment. PET images were analyzed semi-quantitatively by measuring the maximum standardized uptake (SUVmax), total metabolic tumor volume (tMTV), and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were used to assess the relation between potential variables and outcomes. tMTV and TLG were significantly lower in patients with complete response compared with those with partial response at the end of treatment. PET metabolic parameters (tMTV and TLG) were the independent prognostic values for outcome. TMTV and TLG were significantly connected with treatment response and prognosis in pediatric with BL.
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Affiliation(s)
- Zizheng Xiao
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yiwen Mo
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wen Long
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ruping Li
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xinling Li
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuan Wei
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wei Fan
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xu Zhang
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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17
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Zhu J, Zhen Z, Wang J, Sun F, Lu S, Huang J, Zhang Y, Sun X. Outcomes of Burkitt lymphoma with bone marrow involvement or Burkitt leukemia in Chinese children. Pediatr Investig 2021; 5:112-117. [PMID: 34179707 PMCID: PMC8212754 DOI: 10.1002/ped4.12260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/02/2021] [Indexed: 11/07/2022] Open
Abstract
IMPORTANCE Burkitt lymphoma with bone marrow involvement and Burkitt leukemia behave aggressively. Thus far, there are limited data concerning survival and toxicity in Chinese children with Burkitt lymphoma or Burkitt leukemia who have undergone treatment with the non-Hodgkin's lymphoma Berlin-Frankfurt-Münster-90/95 (NHL-BFM-90/95) protocol. OBJECTIVE To analyze outcomes and toxicity in pediatric patients who exhibit Burkitt lymphoma with bone marrow involvement or Burkitt leukemia following treatment with the NHL-BFM-90/95 protocol. METHODS Patients aged <18 years with bone marrow involvement/leukemia who were treated with the NHL-BFM-90/95 protocol, with or without rituximab, in Sun Yat-Sen University Cancer Center from April 2004 to December 2018 were included in this retrospective analysis. RESULTS Twenty-five patients were eligible. Burkitt lymphoma with bone marrow involvement and Burkitt leukemia were present in 10 and 15 patients, respectively. Central nervous system infiltration was not observed in any patients. All patients underwent chemotherapy involving NHL-BFM-90/95 protocol. Six courses of treatment were administered to each patient (v-AA-BB-CC-AA-BB-CC). The BFM-90/95 plus rituximab protocol was administered to 13 patients. The median follow-up interval was 31.9 months (range, 2.5-158 months). Of the 25 patients, four died: three died of tumor progression and one died of therapy abandonment after relief of tumor lysis syndrome. The estimated 5-year event-free survival and overall survival rates were both 85.8% ± 5.0%. INTERPRETATION Chinese pediatric patients who exhibit Burkitt lymphoma with bone marrow involvement or Burkitt leukemia can achieve optimal treatment outcomes and exhibit good tolerance when using the NHL-BFM-90/95 protocol.
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Affiliation(s)
- Jia Zhu
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Zijun Zhen
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Juan Wang
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Feifei Sun
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Suying Lu
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Junting Huang
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Yizhuo Zhang
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
| | - Xiaofei Sun
- Collaborative Innovation Center for Cancer MedicineState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChina
- Department of Pediatric OncologySun Yat‐sen University Cancer CenterGuangzhouGuangdongChina
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18
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Ellis T, Eze E, Raimi-Abraham BT. Malaria and Cancer: a critical review on the established associations and new perspectives. Infect Agent Cancer 2021; 16:33. [PMID: 33985540 PMCID: PMC8117320 DOI: 10.1186/s13027-021-00370-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/29/2021] [Indexed: 01/02/2023] Open
Abstract
Objectives Cancer and malaria both have high incidence rates and are leading causes of mortality worldwide, especially in low and middle-income countries with reduced access to the quality healthcare. The objective of this critical review was to summarize key associations and new perspectives between the two diseases as is reported in existing literature. Methods A critical review of research articles published between 1st January 2000 – 1st July 2020 which yielded 1753 articles. These articles were screened based on a precise inclusion criteria. Eighty-nine eligible articles were identified and further evaluated. Results Many articles reported anti-cancer activities of anti-malarial medicines, including Artemisinin and its derivatives. Other articles investigated the use of chemotherapy in areas burdened by malaria, treatment complications that malaria may cause for cancer patients as well as ways to circumvent cancer related drug resistance. Potential novel targets for cancer treatment, were identified namely oncofoetal chondroitin sulphate and haem, as well as the use of circumsporozoite proteins. A number of articles also discussed Burkitt lymphoma or febrile neutropenia. Conclusions Overall, excluding for Burkitt lymphoma, the relationship between cancer and malaria requires further extensive research in order to define association. There great potential promising new novel anti-cancer therapies using anti-malarial drugs. Graphical abstract Created using BioRender![]()
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Affiliation(s)
- Toby Ellis
- King's College London, School of Cancer and Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, Great Maze Pond, London, SE1 9RT, UK
| | - Elvis Eze
- Malaria no More UK, The Foundry, 17 Oval Way, Vauxhall, London, SE11 5RR, UK
| | - Bahijja Tolulope Raimi-Abraham
- King's College London, School of Cancer and Pharmaceutical Sciences, Institute of Pharmaceutical Science, Waterloo Campus, Franklin Wilkins Building, Stamford Street, London, SE1 9NH, UK.
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19
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Johnston WT, Erdmann F, Newton R, Steliarova-Foucher E, Schüz J, Roman E. Childhood cancer: Estimating regional and global incidence. Cancer Epidemiol 2021; 71:101662. [PMID: 31924557 DOI: 10.1016/j.canep.2019.101662] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/10/2019] [Accepted: 12/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Most of the world's population is not covered by cancer surveillance systems or vital registration, and worldwide/UN-regional cancer incidence is estimated using a variety of methods. Quantifying the cancer burden in children (<15 years) is more challenging than in adults; childhood cancer is rare and often presents with non-specific symptoms that mimic those of more prevalent infectious and nutritional conditions. METHODS A Baseline Model (BM) was constructed comprising a set of quality assured sex- and age-specific cancer rates derived from the US Surveillance, Epidemiology and End Results (SEER) program, for diagnostic groups of the International Classification of Childhood Cancers (ICCC-3) 3rd edition, and information on a known risk factor for endemic Burkitt lymphoma and Kaposi's sarcoma. These rates were applied to global country-level population data for 2015 to estimate the global and regional incidence of childhood cancer. Results were compared to GLOBOCAN 2018, extrapolations from the International Incidence of Childhood Cancer (IICC-3) and estimates from the Global Childhood Cancer (GCC) model (based on IICC-3 data combined with information on health care systems and other parameters). RESULTS The BM estimated 360,114 total childhood cancers occurring worldwide in 2015; 54% in Asia and 28% in Africa. BM estimated standardised rates ranged from ∼178 cases per million in Europe and North America, through to ∼218 cases per million in West and Middle Africa. Totals from GLOBOCAN and extrapolations from the IICC-3 study were lower (44.6% and 34.7% respectively), but the estimate from the GCC model was 10.2% higher. In all models, agreement was good in countries with very high human development index (HDI), but more variable in countries with medium and low HDIs; the discrepancies correlating with registration coverage across these settings. CONCLUSION Disagreements between the BM estimates and other sources occur in areas where health systems are insufficiently equipped to provide adequate access to diagnosis, treatment, and supportive care. Incorporating aetiological evidence into the BM enabled the estimation of the additional burden of Burkitt lymphoma and Kaposi sarcoma; similar adjustments could be applied to other cancers, as and when information becomes available.
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Affiliation(s)
- W T Johnston
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom.
| | - Friederike Erdmann
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France; Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Robert Newton
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom; Medical Research Council, Uganda Virus Research Institute (MRC/UVRI) Research Unit on AIDS, Entebbe, Uganda
| | - Eva Steliarova-Foucher
- Section of Cancer Surveillance, International Agency for Research on Cancer (IARC), Lyon, France
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
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20
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De Coninck W, Govaerts D, Bila M, Vansteenkiste G, Uyttebroeck A, Tousseyn T, Politis C. Burkitt lymphoma in children causing an osteolytic lesion in the mandible: A case report. Clin Case Rep 2021; 9:938-943. [PMID: 33598276 PMCID: PMC7869388 DOI: 10.1002/ccr3.3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/01/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022] Open
Abstract
Imaging is the first step in diagnosing a persistent swelling of the jaw. A lymphoma in the jaw typically manifests as a poorly defined osteolytic lesion. A biopsy is mandatory and will result in definite diagnosis.
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Affiliation(s)
- Wouter De Coninck
- Department of Imaging and PathologyFaculty of MedicineOMFS–IMPATH Research GroupCatholic University LeuvenLeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
| | - Dries Govaerts
- Department of Imaging and PathologyFaculty of MedicineOMFS–IMPATH Research GroupCatholic University LeuvenLeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
| | - Michel Bila
- Department of Imaging and PathologyFaculty of MedicineOMFS–IMPATH Research GroupCatholic University LeuvenLeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
| | - Griet Vansteenkiste
- Department of Oral Health SciencesKU LeuvenLeuvenBelgium
- Department of Pediatric DentistryUniversity Hospitals LeuvenLeuvenBelgium
| | - Anne Uyttebroeck
- Department of OncologyKU LeuvenLeuvenBelgium
- Department of Pediatric Hematology and OncologyUniversity Hospitals LeuvenLeuvenBelgium
| | - Thomas Tousseyn
- Department of Imaging and PathologyLeuven Cancer InstituteUniversity Hospitals LeuvenLeuvenBelgium
| | - Constantinus Politis
- Department of Imaging and PathologyFaculty of MedicineOMFS–IMPATH Research GroupCatholic University LeuvenLeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenLeuvenBelgium
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21
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Levy M, Alison M, Fenneteau O, Dourthe ME, Sommet J. Massive renal infiltration by Burkitt lymphoma. Pediatr Int 2021; 63:238-239. [PMID: 33629426 DOI: 10.1111/ped.14485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Michael Levy
- Pediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marianne Alison
- Pediatric Radiology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Odile Fenneteau
- Laboratory of Hematology, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Marie-Emilie Dourthe
- Pediatric Haemato-Immunology Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Julie Sommet
- Pediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
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22
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Ruan W, Febo-Rodriguez L, Daignault C, Gulati N, Narine K, Sher AC, Elghetany MT, Cortes-Santiago N, Fishman DS, Olive AP. Endoscopic ultrasound-guided diagnosis of Helicobacter pylori-associated gastric Burkitt's lymphoma in an adolescent patient: a rare case. Clin J Gastroenterol 2021; 14:88-91. [PMID: 33165831 PMCID: PMC7887014 DOI: 10.1007/s12328-020-01278-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022]
Abstract
Primary gastric Burkitt's lymphoma (BL) is rare in the pediatric population. Furthermore, the association of Burkitt's lymphoma with Helicobacter pylori is not well defined. We report a case of primary gastric Burkitt's lymphoma associated with Helicobacter pylori diagnosed in a pediatric patient. This diagnosis was made with the aid of endoscopic ultrasound (EUS)-guided fine-needle biopsy (FNB). This is one of the first pediatric cases of EUS-guided FNB for the diagnosis of H. pylori-associated gastric BL.
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Affiliation(s)
- Wenly Ruan
- Department of Pediatrics, Section of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine/Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA.
| | - Liz Febo-Rodriguez
- Department of Pediatrics, Section of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine/Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA.
| | - Chelsea Daignault
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Nitya Gulati
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Kalindi Narine
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Andrew Craig Sher
- Department of Radiology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Mohamed Tarek Elghetany
- Department of Pathology and Immunology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Nahir Cortes-Santiago
- Department of Pathology and Immunology, Baylor College of Medicine/Texas Children's Hospital, Houston, TX, USA
| | - Douglas Shawn Fishman
- Department of Pediatrics, Section of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine/Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA
| | - Anthony Peter Olive
- Department of Pediatrics, Section of Gastroenterology, Hepatology, and Nutrition, Baylor College of Medicine/Texas Children's Hospital, 6701 Fannin Street, D1010.18, Houston, TX, 77030, USA
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23
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Blood JD, Khan A, Kamdar K, Foradori DM. Fever, Headache, and Sore Throat in a 7-year-old Girl. Pediatr Rev 2021; 42:S89-S92. [PMID: 33386372 DOI: 10.1542/pir.2019-0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Julia D Blood
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | - Adrita Khan
- Department of Pediatrics, Columbia University Irving Medical Center, New York-Presbyterian Morgan Stanley Children's Hospital, New York, NY
| | - Kala Kamdar
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | - Dana M Foradori
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
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24
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Choi PJ, Park TI, Cooper E, Dragunow M, Denny WA, Jose J. Heptamethine Cyanine Dye Mediated Drug Delivery: Hype or Hope. Bioconjug Chem 2020; 31:1724-1739. [DOI: 10.1021/acs.bioconjchem.0c00302] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Peter J. Choi
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Thomas I−H. Park
- Department of Pharmacology & The Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Private Bag
92019, Auckland 1142, New Zealand
| | - Elizabeth Cooper
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Department of Pharmacology & The Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Private Bag
92019, Auckland 1142, New Zealand
| | - Mike Dragunow
- Department of Pharmacology & The Centre for Brain Research, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Neurosurgical Research Unit, The Centre for Brain Research, University of Auckland, Private Bag
92019, Auckland 1142, New Zealand
| | - William A. Denny
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Jiney Jose
- Auckland Cancer Society Research Centre, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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Burkitt's lymphoma of the prostate presenting as acute urinary retention: a case report. BMC Urol 2020; 20:53. [PMID: 32375712 PMCID: PMC7203870 DOI: 10.1186/s12894-020-00616-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 04/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Non-Hodgkin lymphomas, which include Burkitt’s lymphoma, affect the prostate in only 0.1% of cases. They most commonly present as painless lymphadenopathy elsewhere in the body and can cause abdominal or thoracic pain and systemic symptoms such as fever, weight loss and night sweats. Here we report a rare case of sporadic Burkitt’s lymphoma of the prostate whose initial clinical presentation was acute urinary retention. Case presentation A 28-year-old Caucasian male presented repeatedly with urinary retention. First, he was misdiagnosed with alcohol-induced urinary retention and later with benign prostatic hyperplasia. After the appearance of new symptoms, including hematuria and hydronephrosis, endoscopic and radiographic evaluation was performed. Transurethral biopsy of the prostate secured the diagnosis of Burkitt’s lymphoma. The symptoms receded under chemotherapy and complete remission of the disease was established. Conclusion This case report brings lymphomas into focus as a differential diagnosis for urinary retention in young males. Early use of extensive diagnostic measures is advised in patients with urinary retention for uncertain reasons to make prompt diagnosis and start appropriate treatment early.
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Clinicopathologic Characterization of Children With B-Cell Non-Hodgkin Lymphoma Over 10 Years at a Tertiary Center in Cape Town, South Africa. J Pediatr Hematol Oncol 2020; 42:e219-e227. [PMID: 32332383 DOI: 10.1097/mph.0000000000001709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We characterized B-cell non-Hodgkin lymphoma (NHL) cases over 10 years at a tertiary children's hospital to contribute to the body of knowledge on pediatric lymphoma in developing countries with a high human immunodeficiency virus (HIV) burden. METHODS A retrospective cohort study was carried out using clinical and laboratory records of children newly diagnosed with B-cell NHL from January 2005 to December 2014. RESULTS Seventy-five children ≤15 years of age were included. The majority had Burkitt lymphoma (n=61). Overall, (n=19) were HIV positive and 16% (n=12) had concurrent active tuberculosis. Bulky disease was present in 65.7% (n=46) and 30.1% (n=22) were classified as Lymphomes Malins B risk group C. The 5-year survival estimates for HIV-negative and HIV-positive children were similar in our cohort: 81% versus 79% for event-free survival and 85% versus 83.9% for overall survival. Of 3 children with Burkitt lymphoma, HIV, and Lymphomes Malins B group C, 2 died within 1 year. CONCLUSIONS Irrespective of HIV status, the survival of children in our B-cell NHL cohort compares favorably with cure rates in developed nations, although advanced disease remains associated with a poor prognosis. Characterization of childhood NHL cases contributes to accurate risk stratification and tailored treatment.
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Xie Y, Jia M, Shi J, Tao Y. Inferior prognosis of gastric involvement in patients with gastrointestinal Burkitt Lymphoma. Cancer Med 2020; 9:3107-3114. [PMID: 32160410 PMCID: PMC7196052 DOI: 10.1002/cam4.2975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/30/2020] [Accepted: 02/22/2020] [Indexed: 12/15/2022] Open
Abstract
Due to limited information reported on the clinical characteristics and outcomes of Burkitt lymphoma (BL) patients with gastrointestinal (GI) involvement, here we used the Surveillance, Epidemiology, and End Results (SEER) database to perform our study in a population‐based scale. Extranodal GI involvement was categorized into gastric and intestinal primary sites. A total of 477 BL patients with GI involvement extracted from the SEER database between 2004 and 2015 were included in this study, 112 (23.5%) with the stomach and 365 (76.5%) with the intestine. Our study demonstrated that gastric involvement, older age, male gender, black race, advanced‐stage III/IV, no‐chemotherapy, and earlier years of diagnosis were associated with a significantly worse overall survival (OS) in GI BL patients after adjustment in multivariate analysis, whereas marital status did not significantly influence OS. Notably, BL Patients with gastric involvement had a significantly inferior 5‐year OS in both univariate and multivariate analysis, as compared to those with intestinal involvement (37.8% vs. 70.2%; Univariate: HR = 2.637, P < .001; Multivariate: HR = 1.489, P = .016). In subgroup analysis, we demonstrated that gastric BL patients had a consistently worse OS than intestinal patients regardless of gender, clinical stage and year of diagnosis. Hopefully, with the advances in modern therapy, improved survival has been found in BL patients with GI involvement as a whole, specifically those with gastric involvement (HR = 0.529, P = .011) in recent years of diagnosis. In conclusion, despite the improved survival achieved in recent years, the prognosis of BL patients with gastric involvement is still poor. Novel personalized therapies and better access to intensive care remain to be needed.
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Affiliation(s)
- Yi Xie
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mengyu Jia
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jumei Shi
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Tao
- Department of Hematology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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Abstract
PURPOSE OF REVIEW Burkitt's lymphoma and its leukemic form (Burkitt cell acute lymphoblastic leukemia) are a highly aggressive disease. We review the classification, clinical presentation, histology, cytogenetics, and the treatment of the disease. RECENT FINDINGS Burkitt's lymphoma might be associated with tumor lysis syndrome which is a potentially fatal complication that occurs spontaneously or upon initiation of chemotherapy. Major improvements were made in the treatment of pediatric and adults population using short-course dose-intensive chemotherapy regimens, usually 1 week after a prephase induction. Addition of Rituximab to chemotherapy has become a standard of care. Relapsed/refractory disease has a very poor prognosis and the benefit from autologous/allogeneic hematopoietic stem cell transplant remains uncertain. Rituximab-based short-course dose-intensive chemotherapy is the standard of care of Burkitt's lymphoma even in the immunodeficiency-related form.
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29
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Serine Biosynthesis Pathway Supports MYC-miR-494-EZH2 Feed-Forward Circuit Necessary to Maintain Metabolic and Epigenetic Reprogramming of Burkitt Lymphoma Cells. Cancers (Basel) 2020; 12:cancers12030580. [PMID: 32138178 PMCID: PMC7139810 DOI: 10.3390/cancers12030580] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 02/07/2023] Open
Abstract
Burkitt lymphoma (BL) is a rapidly growing tumor, characterized by high anabolic requirements. The MYC oncogene plays a central role in the pathogenesis of this malignancy, controlling genes involved in apoptosis, proliferation, and cellular metabolism. Serine biosynthesis pathway (SBP) couples glycolysis to folate and methionine cycles, supporting biosynthesis of certain amino acids, nucleotides, glutathione, and a methyl group donor, S-adenosylmethionine (SAM). We report that BLs overexpress SBP enzymes, phosphoglycerate dehydrogenase (PHGDH) and phosphoserine aminotransferase 1 (PSAT1). Both genes are controlled by the MYC-dependent ATF4 transcription factor. Genetic ablation of PHGDH/PSAT1 or chemical PHGDH inhibition with NCT-503 decreased BL cell lines proliferation and clonogenicity. NCT-503 reduced glutathione level, increased reactive oxygen species abundance, and induced apoptosis. Consistent with the role of SAM as a methyl donor, NCT-503 decreased DNA and histone methylation, and led to the re-expression of ID4, KLF4, CDKN2B and TXNIP tumor suppressors. High H3K27me3 level is known to repress the MYC negative regulator miR-494. NCT-503 decreased H3K27me3 abundance, increased the miR-494 level, and reduced the expression of MYC and MYC-dependent histone methyltransferase, EZH2. Surprisingly, chemical/genetic disruption of SBP did not delay BL and breast cancer xenografts growth, suggesting the existence of mechanisms compensating the PHGDH/PSAT1 absence in vivo.
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30
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Peprah S, Ogwang MD, Kerchan P, Reynolds SJ, Tenge CN, Were PA, Kuremu RT, Wekesa WN, Sumba PO, Masalu N, Kawira E, Magatti J, Kinyera T, Otim I, Legason ID, Nabalende H, Dhudha H, Ally H, Genga IO, Mumia M, Ayers LW, Pfeiffer RM, Biggar RJ, Bhatia K, Goedert JJ, Mbulaiteye SM. Risk factors for Burkitt lymphoma in East African children and minors: A case-control study in malaria-endemic regions in Uganda, Tanzania and Kenya. Int J Cancer 2020; 146:953-969. [PMID: 31054214 PMCID: PMC6829037 DOI: 10.1002/ijc.32390] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/25/2022]
Abstract
Endemic Burkitt lymphoma (eBL) is the most common childhood cancer in sub-Saharan African countries, however, few epidemiologic studies have been undertaken and none attempted enrolling cases from multiple countries. We therefore conducted a population-based case-control study of eBL in children aged 0-15 years old in six regions in Northern Uganda, Northern Tanzania and Western Kenya, enrolling 862 suspected cases and 2,934 population controls (response rates 98.5-100%), and processing ~40,000 vials of samples using standardized protocols. Risk factor questionnaires were administered, and malaria period prevalence was measured using rapid diagnostic tests (RDTs). A total of 80.9% of the recruited cases were diagnosed as eBL; 61.4% confirmed by histology. Associations with eBL risk were computed using logistic regression models adjusted for relevant confounders. Associations common in at least two countries were emphasized. eBL risk was decreased with higher maternal income and paternal education and elevated with history of inpatient malaria treatment >12 months before enrollment. Reporting malaria-attributed fever up to 6 months before enrollment and malaria-RDT positivity at enrollment were associated with decreased eBL risk. Conversely, reporting exposure to mass malaria suppression programs (e.g., indoor residual insecticide) was associated with elevated risk. HIV seropositivity was associated with elevated eBL risk, but the relative impact was small. The study shows that it is feasible to conduct networked, multisite population-based studies of eBL in Africa. eBL was inversely associated with socioeconomic status, positively associated with inpatient malaria treatment 12 months ago and with living in areas targeted for malaria suppression, which support a role of malaria in eBL.
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Affiliation(s)
- Sally Peprah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Martin D. Ogwang
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Patrick Kerchan
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Steven J. Reynolds
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Pamela A. Were
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Robert T. Kuremu
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | - Walter N Wekesa
- EMBLEM Study, Moi University College of Health Sciences, Eldoret, Kenya
| | | | | | - Esther Kawira
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Josiah Magatti
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Tobias Kinyera
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Isaac Otim
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Ismail D. Legason
- EMBLEM Study, Kuluva Hospital, Kuluva, Arua & African Field Epidemiology Network, Kampala, Uganda
| | - Hadijah Nabalende
- EMBLEM Study, St. Mary’s Hospital, Lacor, Gulu & African Field Epidemiology Network, Kampala, Uganda
| | - Herry Dhudha
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Hillary Ally
- EMBLEM Study, Bugando Medical Center, Mwanza, Tanzania
| | - Isaiah O. Genga
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Mediatrix Mumia
- EMBLEM Study, Academic Model Providing Access To Healthcare (AMPATH), Eldoret, Kenya
| | - Leona W. Ayers
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Robert J. Biggar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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Xuereb G, Borg J, Apap K, Borg C. The snoring 2-year-old boy: a case of primary nasopharyngeal Burkitt's lymphoma. BMJ Case Rep 2020; 13:13/1/e233536. [PMID: 31980479 DOI: 10.1136/bcr-2019-233536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Sporadic Burkitt's lymphoma affecting the nasopharyngeal region is an extremely rare disease, especially in infants. We describe the case of a 2-year-old boy who presented to the ear, nose and throat department with a history of snoring, blood-stained rhinorrhoea and symptoms consistent with upper respiratory tract infections. Physical examination revealed massive cervical lymphadenopathy. MRI of the head and neck showed a mass lesion in the nasopharynx with bilateral lymph node enlargement. Debulking of the mass was performed and biopsies were sent for histology, which confirmed Burkitt's lymphoma. The patient was treated with complex chemotherapy and had a good clinical response. The patient remains in remission after 6 years.
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Affiliation(s)
- Gerd Xuereb
- Foundation Programme Malta, Mater Dei Hospital, Msida, Malta .,Faculty of Medicine & Surgery, University of Malta, Msida, Malta
| | - Justine Borg
- Faculty of Medicine & Surgery, University of Malta, Msida, Malta
| | - Kurt Apap
- Faculty of Medicine & Surgery, University of Malta, Msida, Malta.,Emergency Department, Mater Dei Hospital, Msida, Malta
| | - Charles Borg
- Faculty of Medicine & Surgery, University of Malta, Msida, Malta.,Ear, Nose and Throat Department, Mater Dei Hospital, Msida, Malta
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32
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Yang X, Huang Q, Li A, Chen Y, Xu W, Li J, Wang Y, Fang Y. A long-term retrospective study on sporadic Burkitt lymphoma in chinese population. Medicine (Baltimore) 2020; 99:e18438. [PMID: 32000356 PMCID: PMC7004692 DOI: 10.1097/md.0000000000018438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Burkitt lymphoma (BL), an aggressive malignancy, brings a prognosis varying among children, adolescents, and adults. Most of previous retrospective studies of BL focused on a part of population. This study aimed to find the leading prognostic factors in BL among patients of different age groups. World Health Organization classification of lymphoid neoplasms in 2008 and revision in 2016 were used as diagnostic criteria for BL. We compared the laboratory results and clinical manifestations in 2 age groups by Kaplan-Meier survival analysis. Our study strongly indicated that age >14 years and lactate dehydrogenase >570 U/L were 2 powerful prognostic factors for BL. The results indicated that poor prognosis may be for the poor tolerance and low dose of drugs in adolescents and adults.
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Affiliation(s)
- Xiaoyun Yang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University
- Key Laboratory of Hematology, Nanjing Medical University
| | - Qianru Huang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University
- Key Laboratory of Hematology, Nanjing Medical University
| | - An Li
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University
- Key Laboratory of Hematology, Nanjing Medical University
| | - Yuan Chen
- Department of Otorhinolaryngology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Xu
- Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University
| | - Jianyong Li
- Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University
| | - Yaping Wang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University
- Key Laboratory of Hematology, Nanjing Medical University
| | - Yongjun Fang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University
- Key Laboratory of Hematology, Nanjing Medical University
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33
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Williams LA, Richardson M, Marcotte EL, Poynter JN, Spector LG. Sex ratio among childhood cancers by single year of age. Pediatr Blood Cancer 2019; 66:e27620. [PMID: 30815990 PMCID: PMC6472964 DOI: 10.1002/pbc.27620] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/14/2018] [Accepted: 01/08/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND The male excess in childhood cancer incidence is well-established; however, the underlying biologic mechanisms remain unknown. Examining the association between male sex and childhood cancer by single year of age and tumor type may highlight important periods of risk such as variation in growth and hormonal changes, which will inform etiologic hypotheses. METHODS Using data from the Surveillance, Epidemiology, and End Results (SEER) 18 registries (2000-2015), incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were estimated as the measure of association between male sex and childhood cancer by single year of age (0-19). RESULTS The IRR for male cancer overall was 1.19 (95% CI, 1.18-1.20) and was similar in magnitude at nearly every year of age. Burkitt lymphoma was strongly associated with male sex (IRRs ≥2 at each year of age). Increased incidence was observed among males for acute lymphoblastic leukemia, Hodgkin and non-Hodgkin lymphomas for nearly all years of age. Medulloblastoma was the only central nervous system tumor with a significant male predominance at nearly every age. Male sex displayed a consistent inverse association with nephroblastoma and thyroid carcinoma over the ages studied. CONCLUSIONS Male sex was positively associated with most cancers. The higher incidence rates observed in males remained consistent over the childhood and adolescent periods, suggesting that childhood and adolescent hormonal fluctuations may not be the primary driving factor for the sex disparities in childhood cancer. The observed incidence disparities may be due to sex differences in exposures, genetics, or immune responses.
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Affiliation(s)
- Lindsay A Williams
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Michaela Richardson
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Erin L. Marcotte
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Jenny N Poynter
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Logan G Spector
- Division of Epidemiology & Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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Peprah S, Dhudha H, Ally H, Masalu N, Kawira E, Chao CN, Genga IO, Mumia M, Were PA, Kinyera T, Otim I, Legason ID, Biggar RJ, Bhatia K, Goedert JJ, Pfeiffer RM, Mbulaiteye SM. A population-based study of the prevalence and risk factors of low-grade Plasmodium falciparum malaria infection in children aged 0-15 years old in northern Tanzania. Trop Med Int Health 2019; 24:571-585. [PMID: 30843638 PMCID: PMC6499672 DOI: 10.1111/tmi.13225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Northern Tanzania experiences significant malaria-related morbidity and mortality, but accurate data are scarce. We update the data on patterns of low-grade Plasmodium falciparum malaria infection among children in northern Tanzania. METHODS Plasmodium falciparum malaria prevalence (pfPR) was assessed in a representative sample of 819 children enrolled in 94 villages in northern Tanzania between October 2015 and August 2016, using a complex survey design. Individual- and household-level risk factors for pfPR were elicited using structured questionnaires. pfPR was assessed using rapid diagnostic tests (RDTs) and thick film microscopy (TFM). Associations with pfPR, based on RDT, were assessed using adjusted odds ratios (aOR) and confidence intervals (CI) from weighted survey logistic regression models. RESULTS Plasmodium falciparum malaria prevalence (pfPR) was 39.5% (95% CI: 31.5, 47.5) by RDT and 33.4% (26.0, 40.6) by TFM. pfPR by RDT was inversely associated with higher-education parents, especially mothers (5-7 years of education: aOR 0.55; 95% CI: 0.31, 0.96, senior secondary education: aOR 0.10; 95% CI: 0.02, 0.55), living in a house near the main road (aOR 0.34; 95% CI: 0.15, 0.76), in a larger household (two rooms: aOR 0.40; 95% CI: 0.21, 0.79, more than two rooms OR 0.35; 95% CI: 0.20, 0.62). Keeping a dog near or inside the house was positively associated with pfPR (aOR 2.01; 95% CI: 1.26, 3.21). pfPR was not associated with bed-net use or indoor residual spraying. CONCLUSIONS Nearly 40% of children in northern Tanzania had low-grade malaria antigenaemia. Higher parental education and household metrics but not mosquito bed-net use were inversely associated with pfPR.
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Affiliation(s)
- Sally Peprah
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Herry Dhudha
- EpideMiology of Burkitt Lymphoma in East African Children and Minors (EMBLEM) Study, Bugando Medical Center, Mwanza, Tanzania
| | - Hillary Ally
- EpideMiology of Burkitt Lymphoma in East African Children and Minors (EMBLEM) Study, Bugando Medical Center, Mwanza, Tanzania
| | - Nestory Masalu
- EpideMiology of Burkitt Lymphoma in East African Children and Minors (EMBLEM) Study, Bugando Medical Center, Mwanza, Tanzania
| | - Esther Kawira
- EMBLEM Study, Shirati Health and Educational Foundation, Shirati, Tanzania
| | - Colin N Chao
- EpideMiology of Burkitt Lymphoma in East African Children and Minors (EMBLEM) Study, Bugando Medical Center, Mwanza, Tanzania
| | - Isaiah O. Genga
- EMBLEM Study, Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Mediatrix Mumia
- EMBLEM Study, Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Pamela A. Were
- EMBLEM Study, Academic Model Providing Access to Healthcare, Eldoret, Kenya
| | - Tobias Kinyera
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | - Isaac Otim
- EMBLEM Study, African Field Epidemiology Network, Kampala, Uganda
| | | | - Robert J. Biggar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Kishor Bhatia
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - James J. Goedert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Sam M. Mbulaiteye
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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35
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Opanga L, Mulaku MN, Opanga SA, Godman B, Kurdi A. Adverse effects of chemotherapy and their management in Pediatric patients with Non-Hodgkin's Lymphoma in Kenya: A descriptive, situation analysis study. Expert Rev Anticancer Ther 2019; 19:423-430. [PMID: 31023089 DOI: 10.1080/14737140.2019.1606717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Chemotherapy-related side effects and their management in patients with Non-Hodgkin's Lymphoma (NHL) are not well defined in developing countries, including Kenya. This needs addressing considering the high number of patients with cancer in these countries. Consequently, we sought to determine the common side effects of chemotherapy used to treat NHL in pediatric patients and its implications. METHODS Observational study conducted at the Kenyatta National Hospital in patients aged ≤15 years. Some data was collected by reviewing patients' records admitted to the pediatric oncology ward, December 2016 to May 2017; and additional data was collected retrospectively (review of patients' records with NHL, January-2014 to May-2017). Data were analyzed descriptively. RESULTS Overall, out of the identified NHL patients (n = 85), 93% (n = 79) had chemotherapy-related side effects. The majority of patients suffered from side effects were managed; apart from 23% to 24% of the documented anemia and hypersensitivity, respectively. CONCLUSIONS Whilst the majority of the reported side-effects were being managed, the lack of management of some side effects raises real concerns since this indicates either failure to manage or failure to document their management in patients' records, both of which should be addressed appropriately to improve future care.
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Affiliation(s)
- Linda Opanga
- a Department of Pharmacology and Pharmacognosy, School of Pharmacy , University of Nairobi , Nairobi , Kenya
| | - Mercy N Mulaku
- a Department of Pharmacology and Pharmacognosy, School of Pharmacy , University of Nairobi , Nairobi , Kenya
| | - Sylvia A Opanga
- b Department of Pharmaceutics and Pharmacy Practice, Division of Clinical Pharmacy, School of Pharmacy , University of Nairobi , Nairobi , Kenya
| | - Brian Godman
- c Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow , UK.,d Division of Clinical Pharmacology , Karolinska Institute , Stockholm , Sweden.,e School of Pharmacy , Sefako Makgatho Health Sciences University , Garankuwa , South Africa
| | - Amanj Kurdi
- c Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde , Glasgow , UK.,f Department of Pharmacology , College of Pharmacy, Hawler Medical University , Erbil , Iraq
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36
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Egan G, Goldman S, Alexander S. Mature B-NHL in children, adolescents and young adults: current therapeutic approach and emerging treatment strategies. Br J Haematol 2019; 185:1071-1085. [PMID: 30613948 DOI: 10.1111/bjh.15734] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mature B cell lymphomas account for approximately 60% of all cases of non-Hodgkin lymphoma (NHL) in children and adolescents and includes Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL) and other less common histologies. The outcome for patients treated with modern regimens in resource-intensive settings is excellent. Improvements in care have been accomplished through enhanced supportive therapy, including tumour lysis management and incremental refinement of chemotherapy backbones via cooperative group clinical trials in which patients receive risk group-specific intensive chemotherapy. More recent trials have established the safety and efficacy of immunotherapy. Ongoing work is required to address the substantial burden of acute therapy-related toxicity, as well as the identification of effective therapies for those patients with relapsed and refractory disease, for whom outcomes remain very poor. In this review we will summarize the results from recent therapeutic clinical trials, describe the evidence to support the inclusion of rituximab and review the rationale for the investigation of several new categories of novel agents for mature B cell lymphomas in children and adolescents.
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Affiliation(s)
- Grace Egan
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Stan Goldman
- Department of Pediatrics, Medical City Children's Hospital and Texas Oncology, Dallas, TX, USA
| | - Sarah Alexander
- Division of Hematology/Oncology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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37
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Cabras M, Arduino PG, Chiusa L, Broccoletti R, Carbone M. Case Report: Sporadic Burkitt lymphoma misdiagnosed as dental abscess in a 15-year-old girl. F1000Res 2018; 7:1567. [PMID: 32117562 PMCID: PMC7029763 DOI: 10.12688/f1000research.16390.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Burkitt lymphoma (BL) is a non-Hodgkin’s B-cell tumor that can be classified into three variants, based on clinical characteristics and epidemiology: endemic, human immunodeficiency-related and sporadic. Oral sporadic BL is quite an unusual entity, with the gastrointestinal trait being often the first site of appearance. Clinical finding: A 15-year-old patient that presented a symptomatic swelling of the right maxilla, unsuccessfully treated as a primary endodontic disease, displaying solid tissue on CT scan, “starry sky” pattern on oral biopsy, multifocal bone and lymph node uptake on PET. Diagnoses, interventions, and outcomes: A diagnosis of stage IV BL was formulated; Rituximab was then administered for three months according to Inter-B-NHL ritux 2010 protocol and CYM (cytarabine and methotrexate) chemotherapy. The patient was followed-up for three years, with no recurrence. Conclusion: It is important for general dental practitioners to suspect a malignancy in the differential diagnosis of unresponsive odontogenic infections in young healthy patients.
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Affiliation(s)
- Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, 10126, Italy
| | - Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, 10126, Italy
| | - Luigi Chiusa
- Pathology Unit, Città della Salute e della Scienza di Torino, Turin, 10126, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, 10126, Italy
| | - Mario Carbone
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, 10126, Italy
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38
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Ng JYS, Thompson RJ, Lam A, Nigam S. Sporadic Burkitt's lymphoma masquerading as an intussuscepted Meckel's diverticulum in a 9-year-old child. BMJ Case Rep 2018; 2018:bcr-2018-224333. [PMID: 30042102 PMCID: PMC6059232 DOI: 10.1136/bcr-2018-224333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 11/03/2022] Open
Abstract
We report the case of a 9-year-old boy who presented with abdominal pain and was found to have an intussusception with a sporadic Burkitt's lymphoma (BL) lead point. Our case was unusual in that the patient did not present with the typical clinical features of BL, nor was he in a high-risk demographic for this uncommon disease.
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Affiliation(s)
| | | | - Alfred Lam
- Pathology, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Sonu Nigam
- Pathology, Gold Coast University Hospital, Southport, Queensland, Australia
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39
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Kapitančukė M, Vaščiūnaitė A, Augustinienė R, Sakalinskienė J, Kleinotienė G. Primary gastric Burkitt lymphoma-induced anaemia: a case report and a literature review. Acta Med Litu 2018; 25:23-30. [PMID: 29928154 PMCID: PMC6007999 DOI: 10.6001/actamedica.v25i1.3700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background. Primary tumours of the gastrointestinal tract are very uncommon in children. They can present with anaemia caused by gastrointestinal acute or chronic bleeding. One of the most common gastrointestinal tumours is Burkitt lymphoma. This lymphoma is a highly aggressive, rapidly growing B-cell neoplasm, making survival without treatment possible only for a few weeks. For this reason it requires immediate hospitalization and treatment. Case report. We report a case of a gastric Burkitt lymphoma in an adolescent girl who presented with anaemia due to gastrointestinal bleeding. She received out-patient care with iron medications orally due to suspected iron-deficiency anaemia but there was no sufficient effect. The patient was referred to Children’s Oncohematology Department with a progression of symptoms (weakness, fatigue, sound in the ears, and nausea) five months after anaemia was diagnosed in the complete blood count. The imaging tests showed a massive solid tumour with bleeding in the stomach. The final diagnosis was a histologically atypical Burkitt lymphoma. Chemotherapy treatment was started according to NHL-BFM 2004 paediatric protocol. Conclusions. Non-Hodgin’s lymphoma is the most common malignancy of the gastrointestinal tract in children and about 75% of these tumours are Burkitt lymphomas. They can present with anaemia in the complete blood count due to bleeding. Reticulocyte test and serum ferritin level test help to differentiate pathophysiological origin of anaemia. Combination chemotherapy according to standardized protocols is the best current standard of care and has a very good clinical response without unfavourable risk factors.
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Affiliation(s)
| | | | - Rasa Augustinienė
- Department of Radiology, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Jūratė Sakalinskienė
- Centre of Surgery, Subdivision of Endoscopy, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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40
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Pediatric Tonsil Cancer: A National and Institutional Perspective. J Pediatr 2018; 197:255-261.e1. [PMID: 29571929 DOI: 10.1016/j.jpeds.2018.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/13/2017] [Accepted: 01/10/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate childhood and adolescent tonsil cancer incidence and to identify the clinical characteristics indicative of those patients who would benefit from urgent operative intervention. STUDY DESIGN The Surveillance, Epidemiology and End Results 18 database, inclusive of national cancer statistics from 1973 to 2013, provided quantitative tonsil cancer incidence data. An institutional retrospective chart review of pediatric patients diagnosed with tonsil malignancy from January 2013 to January 2017 identified supplementary qualitative clinical presentation information. RESULTS The Surveillance, Epidemiology and End Results 18 database included 138 pediatric patients with tonsil cancer with an age-adjusted incidence rate of 0.021/100 000 patients per year. The majority of cases were unilateral (79.7%), and there was both a male and Caucasian predominance. Non-Hodgkin lymphoma (84.1%) was the most common malignancy, of which Burkitt lymphoma (31.1%), diffuse large B-cell lymphoma (26.8%), and follicular lymphoma (10.1%) were the most common subtypes. Five tonsillar malignancy patients were identified upon institutional chart review. The majority likewise had non-Hodgkin lymphoma and all shared a history of rapid tonsillar enlargement over ≤12 weeks. Significant tonsillar asymmetry was present in 4 patients. Four patients additionally exhibited prominent cervical lymphadenopathy. CONCLUSIONS Pediatric tonsil cancer is rare, with non-Hodgkin lymphoma accounting for the majority of pediatric tonsillar malignancies. A high index of suspicion is appropriate in children who present with relatively rapid tonsil enlargement, tonsillar asymmetry characterized by a difference in tonsillar size of ≥2 degrees on the Brodsky scale, or concurrent prominent cervical lymphadenopathy.
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42
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Bhoopalan SV, Das S. Case 3: Increased Snoring in a 7-year-old Boy. Pediatr Rev 2017; 38:569. [PMID: 29196514 DOI: 10.1542/pir.2016-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Samrat Das
- Department of Pediatrics, University of Nevada Las Vegas, Las Vegas, NV
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43
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Abstract
Cough is one of the most common presenting complaints encountered in primary care settings and the emergency department. In 2010, the Centers for Disease Control and Prevention reported approximately 31 million visits to ambulatory care centers for cough, making cough the most frequent presenting complaint in ambulatory visits (2010 National Ambulatory Medical Care Survey). Significant causes of cough can often be overlooked because it is a common symptom of a myriad of pathologies. We report the case of an otherwise healthy 9-year-old male who presented with worsening cough over a month and a half, subsequently noted to have a mediastinal mass, and diagnosed with lymphoma. We discuss the challenges of diagnosing life-threatening pathologies, which present with common symptoms.
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44
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Oduor CI, Movassagh M, Kaymaz Y, Chelimo K, Otieno J, Ong'echa JM, Moormann AM, Bailey JA. Human and Epstein-Barr Virus miRNA Profiling as Predictive Biomarkers for Endemic Burkitt Lymphoma. Front Microbiol 2017; 8:501. [PMID: 28400759 PMCID: PMC5368269 DOI: 10.3389/fmicb.2017.00501] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 03/10/2017] [Indexed: 11/17/2022] Open
Abstract
Endemic Burkitt lymphoma (eBL) is an aggressive B cell lymphoma and is associated with Epstein-Barr virus (EBV) and Plasmodium falciparum malaria co-infections. Central to BL oncogenesis is the over-expression of the MYC proto-oncogene which is caused by a translocation of an Ig enhancer in approximation to the myc gene. While whole genome/transcriptome sequencing methods have been used to define driver mutations and transcriptional dysregulation, microRNA (miRNA) dysregulation and differential expression has yet to be fully characterized. We hypothesized that both human and EBV miRNAs contribute to eBL clinical presentation, disease progression, and poor outcomes. Using sensitive and precise deep sequencing, we identified miRNAs from 17 Kenyan eBL patient tumor samples and delineated the complement of both host and EBV miRNAs. One human miRNA, hsa-miR-10a-5p was found to be differentially expressed (DE), being down-regulated in jaw tumors relative to abdominal and in non-survivors compared to survivors. We also examined EBV miRNAs, which made up 2.7% of the miRNA composition in the eBL samples. However, we did not find any significant associations regarding initial patient outcome or anatomical presentation. Gene ontology analysis and pathway enrichment of previously validated targets of miR-10a-5p suggest that it can promote tumor cell survival as well as aid in evasion of apoptosis. To examine miR-10a-5p regulatory effect on gene expression in eBL, we performed a pairwise correlation coefficient analysis on the expression levels of all its validated targets. We found a significant enrichment of correlated target genes consistent with miR-10a-5p impacting expression. The functions of genes and their correlation fit with multiple target genes impacting tumor resilience. The observed downregulation of miR-10a and associated genes suggests a role for miRNA in eBL patient outcomes and has potential as a predictive biomarker that warrants further investigation.
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Affiliation(s)
- Cliff I Oduor
- Center for Global Health Research, Kenya Medical Research InstituteKisumu, Kenya; Department of Biomedical Sciences and Technology, Maseno UniversityMaseno, Kenya
| | - Mercedeh Movassagh
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School Worcester, MA, USA
| | - Yasin Kaymaz
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical School Worcester, MA, USA
| | - Kiprotich Chelimo
- Department of Biomedical Sciences and Technology, Maseno University Maseno, Kenya
| | - Juliana Otieno
- Jaramogi Oginga Odinga Teaching and Referral Hospital, Ministry of Medical Services Kisumu, Kenya
| | - John M Ong'echa
- Center for Global Health Research, Kenya Medical Research Institute Kisumu, Kenya
| | - Ann M Moormann
- Program in Molecular Medicine, University of Massachusetts Medical School Worcester, MA, USA
| | - Jeffrey A Bailey
- Program in Bioinformatics and Integrative Biology, University of Massachusetts Medical SchoolWorcester, MA, USA; Division of Transfusion Medicine, Department of Medicine, University of Massachusetts Medical SchoolWorcester, MA, USA
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45
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Mukhtar F, Boffetta P, Risch HA, Park JY, Bubu OM, Womack L, Tran TV, Zgibor JC, Luu HN. Survival predictors of Burkitt's lymphoma in children, adults and elderly in the United States during 2000-2013. Int J Cancer 2017; 140:1494-1502. [PMID: 28006853 DOI: 10.1002/ijc.30576] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/21/2016] [Accepted: 12/08/2016] [Indexed: 02/05/2023]
Abstract
Burkitt's Lymphoma (BL) has three peaks of occurrence, in children, adults and elderly, at 10, 40 and 70 years respectively. To the best of our knowledge, no study has been conducted to assess predictors of survival in the three age groups. We hypothesized that survival predictors may differ by age group. We, therefore, sought to determine survival predictors for BL in these three groups: children (<15 years of age), adults (40-70 years of age) and elderly (>70 years of age). Using the Surveillance, Epidemiology, and End Results (SEER) database covering the years 2000-2013, we identified 797 children, 1,994 adults and 757 elderly patients newly diagnosed with BL. We used adjusted Cox proportional hazards regression models to determine prognostic factors for survival for each age group. Five-year relative survival in BL for children, adults and elderly were 90.4, 47.8 and 28.9%, respectively. Having at least Stage II disease and multiple primaries were associated with higher mortality in the elderly group. In adults, multiple primaries, Stage III or IV disease, African American race and bone marrow primary were associated with increased mortality whereas Stage IV disease and multiple primaries were associated with worse outcome in children. These findings demonstrate commonalities and differences in predictors of survival that may have implications for management of BL patients.
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Affiliation(s)
- Fahad Mukhtar
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Paolo Boffetta
- Icahn School of Medicine, Mount Sinai School of Medicine, Tisch Cancer Institute, New York, NY
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT.,Yale Cancer Center, New Haven, CT
| | - Jong Y Park
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, 33612
| | - Omonigho M Bubu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Lindsay Womack
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Thuan V Tran
- Vietnam National Cancer Hospital, Hanoi, Vietnam.,Vietnam National Institute for Cancer Control, Hanoi, Vietnam
| | - Janice C Zgibor
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
| | - Hung N Luu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
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46
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Teras LR, DeSantis CE, Cerhan JR, Morton LM, Jemal A, Flowers CR. 2016 US lymphoid malignancy statistics by World Health Organization subtypes. CA Cancer J Clin 2016; 66:443-459. [PMID: 27618563 DOI: 10.3322/caac.21357] [Citation(s) in RCA: 729] [Impact Index Per Article: 91.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 12/15/2022] Open
Abstract
Collectively, lymphoid neoplasms are the fourth most common cancer and the sixth leading cause of cancer death in the United States. The authors provide contemporary lymphoid neoplasm statistics by subtype based on the 2008 World Health Organization classifications, including the most current US incidence and survival data. Presented for the first time are estimates of the total numbers of US lymphoid neoplasm cases by subtype as well as a detailed evaluation of incidence and survival statistics. In 2016, 136,960 new lymphoid neoplasms are expected. Overall lymphoma incidence rates have declined in recent years, but trends vary by subtype. Precursor lymphoid neoplasm incidence rates increased from 2001 to 2012, particularly for B-cell neoplasms. Among the mature lymphoid neoplasms, the fastest increase was for plasma cell neoplasms. Rates also increased for mantle cell lymphoma (males), marginal zone lymphoma, hairy cell leukemia, and mycosis fungoides. Like incidence, survival for both mature T-cell lymphomas and mature B-cell lymphomas varied by subtype and by race. Patients with peripheral T-cell lymphomas had among the worst 5-year relative survival (36%-56%, depending on race/sex), while those with mycosis fungoides had among the best survival (79%-92%). For B-cell lymphomas, 5-year survival ranged from 83% to 91% for patients with marginal zone lymphoma and from 78% to 92% for those with hairy cell leukemia; but the rates were as low as 47% to 63% for patients with Burkitt lymphoma and 44% to 48% for those with plasma cell neoplasms. In general, black men had the lowest survival across lymphoid malignancy subtypes. These contemporary incidence and survival statistics are useful for developing management strategies for these cancers and can offer clues regarding their etiology. CA Cancer J Clin 2016;66:443-459. © 2016 American Cancer Society.
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Affiliation(s)
- Lauren R Teras
- Strategic Director, Hematologic Cancer Research, Epidemiology Research Program, American Cancer Society, Atlanta, GA
| | - Carol E DeSantis
- Director, Breast and Gynecological Cancer Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - James R Cerhan
- Professor and Chair, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Lindsay M Morton
- Senior Investigator, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Christopher R Flowers
- Director, Lymphoma Program, Department of Hematology and Oncology/Winship Cancer Institute, Emory University, Atlanta, GA
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47
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Chemotherapy in Children with Head and Neck Cancers: Perspectives and Review of Current Therapies. Oral Maxillofac Surg Clin North Am 2016; 28:127-38. [PMID: 26614705 DOI: 10.1016/j.coms.2015.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cancers of the head and neck in children represent a heterogeneous group of malignancies requiring a variety of treatment modalities. In many instances of childhood head and neck cancers, chemotherapy will be required for treatment, often in conjunction with surgery and/or radiation therapy. Chemotherapy in children with head and neck cancers poses unique challenges in terms of immediate as well as long-term toxicities. This article focuses on the common chemotherapeutic agents, with a particular focus on early and late effects, used in the treatment of children with head and neck cancers.
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48
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Nam S, Kang J, Choi SE, Kim YR, Baik SH, Sohn SK. Xanthogranulomatous Appendicitis Mimicking Residual Burkitt's Lymphoma After Chemotherapy. Ann Coloproctol 2016; 32:83-6. [PMID: 27218100 PMCID: PMC4865470 DOI: 10.3393/ac.2016.32.2.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 07/29/2015] [Indexed: 02/08/2023] Open
Abstract
The case of a 23-year-old female treated with aggressive high-dose therapy for Burkitt's lymphoma is reported. A positron emission tomography and computed tomography scan after completion of chemotherapy revealed a residual hypermetabolic lesion in the right pelvic cavity. A pelvic magnetic resonance imaging scan showed circumferential wall thickening at the tip of the appendix. A laparoscopic exploration and appendectomy were performed, and a pathologic examination of the resected appendix revealed xanthogranulomatous appendicitis. This is a rare case of a xanthogranulomatous appendicitis mimicking remnant Burkitt's lymphoma after completion of chemotherapy.
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Affiliation(s)
- Soomin Nam
- Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Jeonghyun Kang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Eun Choi
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Ri Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyuk Baik
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Kook Sohn
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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49
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Rowles S, Kharrubi R, Ikeda A. Case 3: Bilateral Facial Edema with Gingival Swelling in a 6-year-old Boy. Pediatr Rev 2016; 37:126-8. [PMID: 26933229 DOI: 10.1542/pir.2014-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Shawn Rowles
- Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV
| | - Rani Kharrubi
- Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV
| | - Alan Ikeda
- Department of Pediatrics, University of Nevada School of Medicine, Las Vegas, NV
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50
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Chen BJ, Chang ST, Weng SF, Huang WT, Chu PY, Hsieh PP, Jung YC, Kuo CC, Chuang YT, Chuang SS. EBV-associated Burkitt lymphoma in Taiwan is not age-related. Leuk Lymphoma 2015; 57:644-53. [DOI: 10.3109/10428194.2015.1076928] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Bo-Jung Chen
- Department of Pathology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan,
| | - Sheng-Tsung Chang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan,
- Department of Nursing, National Tainan Institute of Nursing, Tainan, Taiwan,
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan,
| | - Wan-Ting Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan,
- College of Medicine, Kaohsiung and Chang Gung University, Kaohsiung, Taiwan,
| | - Pei-Yi Chu
- Department of Pathology, St. Martin De Porres Hospital, Chiayi, Taiwan,
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan,
| | - Pin-Pen Hsieh
- Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
- National Defense Medical Center, Taipei, Taiwan,
| | - Yun-Chih Jung
- Department of Pathology, Sin-Lau Christian Hospital, Tainan, Taiwan,
| | - Chun-Chi Kuo
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan,
| | - Yu-Ting Chuang
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan, and
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan,
- Department of Pathology, College of Medicine, Taipei Medical University and National Taiwan University, Taipei, Taiwan
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