Cure 250 Children with Burkitt Lymphoma in Africa

In early January 2022, Nancy, aged 11 years, developed a toothache and a small swelling on her upper gum. Her mother initially treated her with over-the-counter medications, but when the swelling increased, she took her to one clinic after another seeking answers about what was ailing her daughter. Nancy’s condition continued to worsen, and her mother brought her to a major health center in their home district of Oyam in northern Uganda. The health center referred her to our hospital, St. Mary’s Hospital Lacor in Gulu which is not far away from Nancy’s home district. Nancy and her mother arrived at St. Mary’s at the end of January. We found her to be extremely malnourished and she had a very large jaw mass which was painful to the touch. She underwent appropriate tests, including a biopsy of the mass which confirmed that she had Burkitt lymphoma.

Nancy began treatment for Burkitt lymphoma on February 2, 2022. After the first cycle of treatment, her mother who is the bread winner for the family requested that Nancy be discharged so that she could return to work. Nancy’s father had passed away and her mother had four other children to look after. Unfortunately, Nancy did not come back to the hospital on time for her second cycle of treatment. We sent a team to her home to bring her back to us. After a rapid response to the first cycle of treatment, when we saw Nancy at home, her jaw mass had regrown. Because her mother needed to work, her aunt agreed to accompany her back to the hospital. Nancy resumed chemotherapy in late March – eight weeks after her initial cycle of treatment. Her aunt left Nancy alone in the hospital without anyone to look after her. Nancy returned home and her treatment was abandoned for the second time.  

Our team visited Nancy at home at the end of July 2022. Her tumor had regrown since late March. Nancy’s living arrangements were difficult because her mother was remarried and living with her new husband and Nancy was living with her grandmother. We brought the family and community members to Nancy’s home to educate everyone about Burkitt lymphoma, its management, and the importance of adherence to planned treatment as well as the family’s important role. The community members decided to withdraw Nancy’s eldest sister (aged 17 years) from school so that she could take care of her at St. Mary’s. Nancy resumed treatment – we decided to restart all therapy from the beginning to give Nancy the best chance for cure. Her sister has remained with her at the hospital and Nancy has now completed three cycles of therapy but must continue to receive an additional three cycles of therapy. She has responded well to treatment.      

Nancy’s home-life presented us with many challenges. Because her father had passed away, the only financial resources for Nancy and her siblings were derived from her mother’s income. Nancy’s living arrangements were complicated because her mother remarried and left Nancy in her grandmother’s care. Our decision to involve the community was vital in ensuring Nancy’s return to our hospital and adherence to treatment. Without the community’s support and intervention, it would not have been possible for the family to continue to bring Nancy to our hospital for her much needed treatment.       

We would like to thank her community for getting involved and making the difference in Nancy’s care. Thanks to your generous donations, Nancy has received free treatment throughout this year. Thank you again for supporting children like Nancy who deserve every opportunity for a chance for long-term cure.

In late 2011, when Filbert was ten years old, he experienced abdominal pain followed by swelling.  When his abdomen became distended, his father brought him to the Soroti Regional Referral Hospital that was nearby where his family lived.  He was admitted and underwent abdominal surgery. A biopsy of the abdominal mass found during surgery was positive for Burkitt lymphoma.  Because Soroti Hospital could not provide treatment for Filbert, he was referred to our hospital, St. Mary’s Hospital Lacor in Gulu Uganda – over 150 miles from his home.  He was started on the INCTR treatment protocol for Burkitt lymphoma in January 2012 but achieved a partial response to initial therapy.  He was then treated with the second-line regimen intended for patients such as Filbert who do not respond well to first-line treatment. He completed all treatment in October 2012.   After his discharge, he regularly returned to St. Mary’s for follow up visits and remained in remission until he returned for an annual check up in November 2021.

At the time of his November 2021 visit, Filbert was complaining of pain in his stomach. After making appropriate investigations, we learned that he had suffered a very late relapse of Burkitt lymphoma. A relapse this many years after being in remission for nine years is extremely unusual, but not unknown to happen. Filbert was 21 years old at the time of this relapse. He was re-started on the INCTR protocol. He achieved a partial response to first-line treatment and required further treatment with the second-line therapy. At the time of his last review in January 2022, he was in complete remission.

Prior to this late relapse, he had resumed going to school and was a senior in his studies. He did say that his education had been disrupted because of the lockdowns and restrictions that were imposed in Uganda due to the Covid-19 pandemic.  

Filbert wishes to express his thanks to everyone who donates to this project and to everyone in the health care profession who support children with cancer. He wants to become a medical doctor to help those in need.

Thank you to everyone who contributes to this project as your donations ensure that children, adolescents, and young adults receive the care and treatment that they need for this highly curable cancer so that they can fulfill their dreams.