Predictors of survival among children with Burkitt lymphoma treated at a single center in Tanzania: a retrospective cohort study

Abstract

BACKGROUND: Despite improvements in the management of patients with Burkitt lymphoma, the survival rate in low- and middle-income countries remains poor. This study aimed to determine the predictors of 18-month overall survival among children with Burkitt lymphoma. METHODS: A retrospective cohort study was conducted at the Pediatric Oncology unit of Muhimbili National Hospital in Dar-es-salaam, Tanzania. The study included a cohort of 123 children who were diagnosed with Burkitt lymphoma from January 2012 to December 2017. Predictors of mortality were assessed using Cox regression analysis. A two-tailed p-value <0.05 was considered statistically significant. RESULTS: The median age of the patients was seven years and the majority 61.8% (76/123) were males. Abdominal presentation was the most common tumor site in 39% (48/123). The 18-month overall survival rate was 54.0%. Key predictors of mortality included human immunodeficiency virus (HIV) infection (adjusted Hazard ratio [aHR] = 5.12; 95% CI: 1.39-19.0; p < 0.01) and elevated lactate dehydrogenase levels (>500 U/L; aHR = 2.50; 95% CI: 1.14-14.71; p = 0.03). CONCLUSION: Most patients presented with abdominal Burkitt lymphoma. Despite the tumor's high chemosensitivity, treatment response in this cohort was marginal, characterized by moderate overall survival and low event-free survival. HIV infection and elevated lactate dehydrogenase levels were significant predictors of mortality. Improving outcomes will require optimized early diagnosis, HIV screening, and rigorous patient follow-up.