HODGKIN'S DISEASE AFTER TREATMENT FOR BURKITT'S LYMPHOMA: CASE REPORT

Hodgkin's disease and non-Hodgkin's lymphomas are interrelated disorders which havebeen reported to occur either simultaneously or sequentially in the same patient. We reporthere the development of nodular sclerosing type Hodgkin's disease in a patient two decadesafter successful treatment for Burkitt's lymphoma with cyclophosphomide and abdominalresection (AR). While the onset of symptoms after treatment for Burkitt's lymphoma wasseven years definitive diagnosis of Hodgkin's disease was only made 22 years after the initialdiagnosis of Burkitt's lymphoma. The recurrent and solitary nature of the lymphadenopathyand the fact that it was initially reported as reactive hyperplasia is typical of nodularlymphocyte predominant Hodgkin's disease. We believe that there was a transitory periodof the malignancy as nodular lymphocyte predominant klodgkin's disease

Hodgkin's disease after treatment for Burkitt's lymphoma: case report

(East African Medical Journal: 2001 78(6): 334-336

Treatment of Burkitt lymphoma in equatorial Africa using a simple three-drug combination followed by a salvage regimen for patients with persistent or recurrent disease.

Prior to the introduction of the International Network for Cancer Treatment and Research (INCTR) protocol INCTR 03-06, survival of patients with Burkitt lymphoma at four tertiary care centres in equatorial Africa was probably no more than 10-20%. The results reported here for 356 patients have demonstrated marked improvement in survival through the use of a uniform treatment protocol consisting of cyclophosphamide, methotrexate, vincristine, and intrathecal therapy, and the introduction of non-cross resistant second-line (salvage) therapy, consisting of ifosfamide, mesna, etoposide and cytarabine, when patients failed to achieve a complete response to first-line therapy or relapsed early. Overall survival rates of 67% and 62% were observed at 1 and 2 years (relapse is rare after 1 year of remission). Of interest was the small impact of cerebrospinal fluid (CSF) and bone marrow involvement on outcome. However, the presence or absence of abdominal involvement clearly defined two prognostic groups. An additional finding was the association between CSF pleocytosis and orbital tumours, suggesting that spread of tumour cells to the central nervous system may sometimes occur via direct involvement of cranial nerves in the orbit. Survival rates may be increased in patients with abdominal involvement by combining first- and second-line therapy, but verification will require a further clinical study