Cure 250 Children with Burkitt Lymphoma in Africa

Ronald’s grandfather brought him to St Mary’s Hospital Lacor in Gulu, Uganda after Ronald experienced a one-month history of progressive painful swelling of his right jaw. They arrived at St Mary’s in June amidst the Covid-19 pandemic after a long journey from their home in the north western part of the country.

When ten-year old Ronald was admitted to the hospital, he was a very ill. His face was very deformed due to gross swelling of the jaw and he had a visible mass protruding through his mouth. Ronald had difficulty with speech and eating. He also had loosening of his teeth. He underwent other tests which did not show spread of disease to other parts of his body. His clinical features were classical for Burkitt lymphoma and a biopsy taken of the jaw mass confirmed our suspected diagnosis.

He was then started on first-line chemotherapy according to the INCTR treatment protocol for Burkitt lymphoma. After the first cycle, Ronald’s grandfather made the decision to take Ronald home – which is a very long distance from St Mary’s Hospital – for financial reasons. The family’s income is derived from subsistence farming. Ronald’s biological father does not provide financial support for Ronald and his eight siblings. Therefore, Ronald’s grandfather and mother must work to feed and care for the family.

Ronald missed his appointment for the next cycle of therapy. After contacting his grandfather, we learned that he had no money to bring Ronald back to St Mary’s. Their home district was under lockdown due to Covid-19 and no public transportation was available. The hiring of a driver with a private vehicle was an option. However, this option was both cost-prohibitive and illegal. With the help of a local NGO, St Mary’s was able to transport Ronald back to the hospital to continue treatment.

Even though he had a five-week delay after the first cycle of therapy, Ronald did not have any signs of progression of disease when he returned. He completed the second cycle of therapy and is just beginning the third cycle. He is doing well and has had a complete resolution of his jaw tumor. In an aggressive cancer such as Burkitt lymphoma, it is important that all planned treatment is completed and without unnecessary delays so that a child with this cancer has the best chance for cure. Ronald is now staying at the hospital’s Family Home to ensure that he completes treatment and avoids delays due to lack of transportation caused by restrictions imposed during the Covid-19 pandemic.

Thanks to your generous donations to this project, poor children from rural villages have access to the necessary treatment for Burkitt lymphoma. Your support provides families and children with the hope of long-lasting cure. Thank you again for your support.

Allan, a 14-year old boy, came to St Mary’s Hospital Lacor in January.  He was accompanied by his mother. They reported that he had a three-month history of progressive and painful abdominal swelling. He stated that he had also lost weight, particularly in the month prior to admission to St Mary's. On examination, we found him to be very ill and severely malnourished. In addition to the visible abdominal distention, we could easily feel a well-defined mass in his upper right abdomen.  

Allan immediately underwent a series of tests that showed that he had disease that was widespread throughout his abdomen. He had multiple masses in his liver and a very large mass within his abdominal cavity. A biopsy taken of the abdominal mass confirmed our suspected diagnosis of Burkitt lymphoma. He promptly began the appropriate treatment for this type of cancer which consists of six cycles of chemotherapy. In addition to chemotherapy, he received nutritional rehabilitation. The first cycle of chemotherapy was a tough one for Allan. Because of the extent of his disease, Allan had to be carefully supported prior to the initiation of the first cycle and monitored closely once treatment began to ensure that his kidneys were working well – especially when his lymphoma began to break down - which can sometimes result in kidney failure and death. After he made it through these first few days, he developed dangerously low levels of infection-fighting white blood cells that also had the potential to be life-threatening. He recovered from the first cycle and went on to complete the rest of his chemotherapy with minimal side effects. All signs of his Burkitt lymphoma disappeared after the first two cycles of therapy.

Before Allan became ill, he lived with his parents and four siblings in the Lira District in northern Uganda. He performed very well in school.  He helped his mother in the family’s garden to ensure that they had sufficient food to eat. He also helped his mother when she needed to go to the market to buy other food and supplies for the family. During treatment, he was always concerned about his mother because she was the sole provider for the family as sadly, his father was mentally unwell. The hospital staff thought that he was very mature for his age.   

Now that he has completed treatment, Allan cannot wait to resume his normal life.  He wants to continue to support his mother in whatever ways he can. He also wishes to return to school and complete his education so that one day, he can become a teacher - his big dream for the future.

Thank you to everyone who supports this project. Without your donations, children like Allan would not be able to receive an accurate diagnosis and the appropriate care and treatment for this highly curable cancer. Children with Burkitt lymphoma need to be given the chance for cure – no matter how extensive their tumor may be at the time of diagnosis – so that they, too, can be given hope to fulfill their dreams for the future.