Factors determining the outcome of management of patients with Burkitt's lymphoma at the University College Hospital Ibadan, Nigeria--an eleven year review.

In recent times, our experience in the chemotherapy of Burkitt's lymphoma patients in Ibadan, Nigeria has been that of poor outcome, hence this study was undertaken to determine the factors leading to the poor results of chemotherapy of Burkitt s lymphoma in Ibadan. A retrospective analysis of Burkitt s Lymphoma patients seen over eleven year period, between January 1987 to December 1997 at the Paediatrics and Haematology Departments of the University College Hospital, Ibadan was carried out. There were 67 patients, mean age 11+5 years (range 4 to 30 years), 42 males, 25 female giving M:F ratio of 1.7:1. Majority of the patients (76.2%) were stage D, only 4.5% were stages A and of the 67 patients, only 57 (83.6%) had chemotherapy, 40 of whom had COAP, 8 had COMP and 9 patients had either cyclophosphamide or cytosar as monotherapy. Only 22.8% of patients that received chemotherapy went into complete remission. In this study, we observed a declining overall complete remission rate of 22.8% (compared to 47% in 1979) in Burkitt s Lymphoma patients. The presence of large amount of fake drugs in the Nigerian market may imply that some of the cytotoxic drugs used in these patients could have been fake drugs. We suggest that the government should subsidize the therapy of these patients as well as eradicate the presence of fake drugs in the market, thereby increasing the chances of a cure.