Survival patterns for pediatric BL treated with various chemotherapy regimens in SSA over 5 decades
| Location . | Years . | Sample size, n . | Regimen . | Chemotherapy dose, mg/m2 per cycle . | Survival analysis . | Stage III/IV survival, % . | TRM, % . | Cohort survival, % . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cyclophos . | MTX . | VCR . | Doxo . | Pred . | |||||||||
| Uganda | 1967-1970 | 57 | Cyclophos | 1200 | — | — | — | — | OS | 24/0 | 18 | 30 | |
| Ghana | 1968-1972 | 110 | Cyclophos | 1200 | — | — | — | — | 2-y OS | 31/20 | NR | 44 | |
| Uganda | 1967-1977 | 280 | Various* | OS | 50/25 | NR | 39 | ||||||
| Lilongwe, Malawi | 1991-1997 | 73 | Cyclophos | 1200 | — | — | — | — | OS | 33 | NR | 55 | |
| Blantyre, Malawi | 2000-2002 | 42 | Plus hdMTX | 500 | 2000 | 2 | — | 420 | 1-y EFS | 24/25 | 33 | 33 | |
| GFAOP 3 | 2001-2004 | 187 | COPM | 1500 | 3000 | 1.5 | — | 300 | 1-y EFS | 52/36 | 21 | 56 | |
| GFAOP 6 | 2005-2008 | 178 | Cyclophos | 1200 | — | — | — | — | 1-y EFS | 30/16 | 8 | 33 | |
| Cameroon | 2006-2008 | 95 | Cyclophos | 1200-1800 | — | — | — | — | 1-y EFS | 33 | 7 | 35 | |
| Kenya | 2003-2011 | 428 | Plus doxo | 1200 | — | 1.5 | 60 | Tapering | 1-y EFS | NR | NR | 31 | |
| Blantyre, Malawi | 2010-2012 | 70 | Plus VCR | 1200-1800 | — | 1.5 | — | — | 1-y EFS | 24/32 | 3 | 48 | |
| Lilongwe, Malawi | 2011-2013 | 74 | CHOP-like | 800 | — | 1.5 | 40 | 300 | 18-mo OS | 26 | 8 | 29 | |
| GFAOP 7 | 2009-2015 | 400 | COPM | 1500 | 3000 | 1.5 | — | 420 | 1-y OS | 60/31 | 12 | 60 | |
| Lilongwe, Malawi | 2013-2015 | 73 | CHOP-like | 800 | — | 1.5 | 40 | 300 | 18-mo OS | 28/17 | 16 | 29 | |
| Uganda | 2012-2017 | 180 | COM | 900 | 15 | 1.5 | — | — | 4-y OS | 42 | NR | 44 | |
| Location . | Years . | Sample size, n . | Regimen . | Chemotherapy dose, mg/m2 per cycle . | Survival analysis . | Stage III/IV survival, % . | TRM, % . | Cohort survival, % . | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cyclophos . | MTX . | VCR . | Doxo . | Pred . | |||||||||
| Uganda | 1967-1970 | 57 | Cyclophos | 1200 | — | — | — | — | OS | 24/0 | 18 | 30 | |
| Ghana | 1968-1972 | 110 | Cyclophos | 1200 | — | — | — | — | 2-y OS | 31/20 | NR | 44 | |
| Uganda | 1967-1977 | 280 | Various* | OS | 50/25 | NR | 39 | ||||||
| Lilongwe, Malawi | 1991-1997 | 73 | Cyclophos | 1200 | — | — | — | — | OS | 33 | NR | 55 | |
| Blantyre, Malawi | 2000-2002 | 42 | Plus hdMTX | 500 | 2000 | 2 | — | 420 | 1-y EFS | 24/25 | 33 | 33 | |
| GFAOP 3 | 2001-2004 | 187 | COPM | 1500 | 3000 | 1.5 | — | 300 | 1-y EFS | 52/36 | 21 | 56 | |
| GFAOP 6 | 2005-2008 | 178 | Cyclophos | 1200 | — | — | — | — | 1-y EFS | 30/16 | 8 | 33 | |
| Cameroon | 2006-2008 | 95 | Cyclophos | 1200-1800 | — | — | — | — | 1-y EFS | 33 | 7 | 35 | |
| Kenya | 2003-2011 | 428 | Plus doxo | 1200 | — | 1.5 | 60 | Tapering | 1-y EFS | NR | NR | 31 | |
| Blantyre, Malawi | 2010-2012 | 70 | Plus VCR | 1200-1800 | — | 1.5 | — | — | 1-y EFS | 24/32 | 3 | 48 | |
| Lilongwe, Malawi | 2011-2013 | 74 | CHOP-like | 800 | — | 1.5 | 40 | 300 | 18-mo OS | 26 | 8 | 29 | |
| GFAOP 7 | 2009-2015 | 400 | COPM | 1500 | 3000 | 1.5 | — | 420 | 1-y OS | 60/31 | 12 | 60 | |
| Lilongwe, Malawi | 2013-2015 | 73 | CHOP-like | 800 | — | 1.5 | 40 | 300 | 18-mo OS | 28/17 | 16 | 29 | |
| Uganda | 2012-2017 | 180 | COM | 900 | 15 | 1.5 | — | — | 4-y OS | 42 | NR | 44 | |
Groupe Franco-Africain d’Oncologie Pédiatrique (GFAOP) 3 includes Cameroon, Madagascar, and Senegal; GFAOP 6 includes Cameroon, Madagascar, Senegal, Burkina-Faso, Ivory Coast, and Mali; and GFAOP 7 includes GFAOP 6 + Togo.
—, not applicable; CHOP-like, cyclophosphamide, doxorubicin, vincristine, and prednisone; COPM, cyclophosphamide, vincristine, prednisone, and hdMTX for 2 cycles, followed by hdMTX plus mini-cytarabine (500 mg/m2 per cycle) for 2 cycles; cyclophos, cyclophosphamide monotherapy; Doxo, doxorubicin; EFS, event-free survival; hdMTX, high-dose MTX; NR, not reported; Pred, prednisone; TRM, treatment-related mortality; VCR, vincristine.
The various regimens used in Uganda from 1967 to 1977 included cyclophosphamide monotherapy (1200 mg/m2 per cycle), COM (cyclophosphamide 900 mg/m2 per cycle, vincristine 2 mg/m2 per cycle, and MTX 45 mg/m2 per cycle), and cyclophosphamide 1200 mg/m2 per cycle, vincristine 1.4 mg/m2 per cycle, MTX 60 mg/m2 per cycle, and cytarabine, 750 mg/m2 per cycle.