Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin’s lymphoma (NHL). With high-dose combination chemotherapy cure rates are excellent but associated with higher rates of infections, and morbidity. Treatment for HIV positive Burkitt lymphoma is similar to HIV negative Burkitt lymphoma along with anti-retroviral therapy. In resource constrained setting offering intensive chemotherapy sometime is difficult. There is scarcity of data regarding use of metronomic chemotherapy in aggressive lymphomas. Results: Here we present outcome and review of literature of child, diagnosed with Burkitt lymphoma and HIV who was treated with metronomic chemotherapy. After year of follow-up he is disease free.

Hodgkin lymphoma is a haematolymphoid malignancy seen in pediatric and adult age groups with an excellent outcome. The current priority of the treatment has been a reduction of acute and chronic morbidities without compromising outcomes. PET-CT scan is an integral component in prognosticating and determining outcomes in Hodgkin lymphoma. Recent studies have highlighted the role of interim PET-CT scan in choosing future therapy. The evidence to support the role of interim PET-CT scan in childhood Hodgkin lymphoma is limited. The aim of the study is to analyse the role of interim PET-CT in the management of childhood HL, and to investigate survival outcomes of children treated at our institute. This is a retrospective study and included all the children with HL treated at our institute in last five years. All the children were treated as per ESMO guidelines. Interim PET-CT scan was done after two cycles of chemotherapy. The correlation of various possible risk factors with the outcomes was examined. Only the interim PET/CT findings were associated with the results. At median follow-up of 34 months, the event free survival (EFS) was 95.7% and overall survival (OS) was 100%. Interim PET-CT plays an important role in treatment modification without compromising on the outcomes in children with HL. Survival rates were consistent with those reported in published literature.

Age, presenting total leukocyte counts, steroid response and cytogenetics are known prognostic markers for acute lymphoblastic leukemia (ALL). Measurable Residual Disease (MRD) (or minimal residual disease) after induction chemotherapy is well accepted prognostic markers in childhood leukemia. In resource constrained countries evaluation of MRD either not widely available or increases the cost of treatment. We retrospectively analyzed data of patients, treated with non-MRD based protocol, to see correlation of known risk factors and risk groups with end of induction MRD. Children with acute lymphoblastic leukemia treated with IC-BFM 2002 (Non-MRD based protocol) and end of the induction MRD was done. Day15 bone marrow morphology and risk groups were significantly associated with MRD level. All standard risk patients except one had MRD negative. Significant number of intermediate risk group and high risk group had positive MRD. In resource constrained settings, MRD can be avoided in standard risk, but cannot be avoided in higher risk group for optimization of therapy.