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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Including Mozambique in INCTR’s Sub-Saharan African Network for the treatment of Lymphoma Sidnei Epelman, M.D.
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Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Burkitt´s Belt
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma BL Study 5 participants centers in 4 sub-Saharan African countries – Kenya – Nigeria – Tanzania – Uganda Purpose – Characterize presentation features of BL – Assess response and treatment outcome
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Study objectives Primary – Characterize presentation features of Burkitt’s Lymphoma in African countries – Assess response, EFS, DFS and OS – Characterize pattern of CNS disease and relapse – Assess toxicities to the regimen Secondary – Pattern of gene expression in African BL – Assess levels of sEBV DNA and correlate with clinican features and response to therapy
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma First-Line Treatment Treatment Groups Low Risk Group Patients with a single extra-abdominal tumor of less than 10 cm in size, in its widest diameter. High Risk Group All patients who do not meet the definition of low risk.
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma First-Line Treatment Low Risk Group Day 1 Vincristine 1.4 mg/m2 h IV Day 1 Cyclophosphamide 1200 mg/m2 IV Day 1 Methotrexate 75 mg/m2 IV Day 1 Methotrexate intrathecal (IT) Day 4 Cytarabine IT Day 8 Methotrexate IT Total of 3 cycles of therapy. Every 14 days
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma First-Line Treatment High Risk Group Day 1 Vincristine 1.4 mg/m2, Day 1 Cyclophosphamide 1200 mg/m2 IV Day 1 Methotrexate 75 mg/m2, IV Day 1 Methotrexate intrathecal Day 4 Cytarabine IT Day 8 Methotrexate IT Total of 6 cycles of therapy Every 14 days CNS TREATMENT High risk patients without CNS disease – as above during the first 3 cycles of therapy. High risk patient with CNS disease - as described above during all 6 cycles of therapy.
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Second-line Treatment Days 1-3 Etoposide 60 mg/m2 IV Days 1-3 Ifosfamide 1500 mg/m2 IV Days 1-3 Mesna 300 mg/m2 IV mixed with ifosfamide and then 300 mg/m2 mesna Injection for 3 additional doses at hours 3, 6 and 9 post ifosfamide.. Days 1-3 Cytarabine 100 mg/m2 IV Day 1 Methotrexate IT Day 4 Cytarabine IT Day 8 Methotrexate IT Total of 6 cycles of therapy Every 14 days
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Supported from INCTR Drugs Data management – Data base – Registration – Monitoring for errors – Assistance with analysis of data Consultation in specific cases when needed Training and Education in Santa Marcelina - SP
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Cost-effective treatment
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Mozambique Participation Dr Joseph Ferro – Pathologist – Registry of Breira Cancer Hospital in Maputo
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma On going Programms in Lusophone Africa Development of the program for early diagnosis in Retinoblastoma - all materials (video, posters, cards, etc) are already in Portuguese and Swahili. Implementation of Palliative Care Program - PAX program - (education and training can be provided at Santa Marcelina Hospital ) Development of Protocol for Burkitt´s lymphoma (results will presented by Melissa Adde) Training and Education in Pediatric Oncology at Santa Marcelina Hospital in Sao Paulo - fellow from Angola Raising funds (e.g, concert in London)
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Sidnei Epelman, M.D. Director – INCTR Brazil Including Mozambique in INCTR’s sub-Saharan African Network for the treatment of Lymphoma Retinoblastoma video in Swahili
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