| Nov 15, 2017
Anthony Has a Reason to Smile
By Dr. Stella Kyoyagala | Lead Pediatrician, St Mary's Hospital Lacor
Anthony Awaiting Discharge after Treatment
In December of 2016, Anthony came to our hospital, St Mary’s Hospital Lacor in Gulu, Uganda. He was 11 years old. Anthony is from the Moyo District in the north eastern part of the country and he lives over 100 kilometers from Gulu. His father is raising Anthony and his two brothers – one brother is Anthony’s twin – as a single parent. When Anthony arrived on our Burkitt’s ward, he presented with swelling of his abdomen which had been rapidly progressing for one month. His abdominal swelling was associated with pain and he also had fevers during the night that were followed by sweating. When we examined him, he had a distended abdomen and we could easily palpate or feel masses within his abdomen. He also had involvement of his spleen. But, he was able to walk in spite of his painful and distended abdomen. And, Anthony was actually able to give us most of the history of his illness. He underwent a biopsy in order to diagnose what we suspected was Burkitt lymphoma (BL).
Once we received confirmation of Anthony’s diagnosis as being BL, he was started on treatment right away. He developed a common side effect of chemotherapy called neutropenia which means that his infection fighting white blood cells in his body were too low. Therefore, he was at risk of acquiring a serious infection that might potentially result in the loss of his life. His next cycle of chemotherapy had to be delayed in order to allow his bone marrow which makes these important blood cells to recover. But, Anthony was strong and he managed to get through this period of neutropenia despite our own limited resources to protect him against life-threatening infections. Although he received a second cycle of our first line therapy without any side effects, an evaluation of his disease status showed that he was not responding to treatment as we had hoped.
Therefore, we made the decision to change him to the second line therapy that consists of drugs that are considered to be non-cross resistant (and different) to those chemotherapy drugs he had received during his first two cycles. The drugs used in the second line therapy are also highly effective against BL when our first line therapy does not work as well as we expect it to. With the ability to provide the second line therapy, we were able to offer Anthony and his family hope. The second line therapy has more drugs with the potential to cause more harmful side effects. To our joy, Anthony completed all of the four planned second line treatment cycles without major side effects. But, most importantly, he had a complete resolution of his BL.
Anthony comes for regular follow up visits. I saw him recently and he was very happy and healthy. His life is normal again, he is with his family and he cannot wait to go back to school as soon as the new term begins. His smile said it all – “thank you, thank everyone and every kind heart that gives to save lives like mine and many of the children with Burkitt Lymphoma”.