Evaluating Patient Reported Outcomes for Pediatric Burkitt Lymphoma Treatment in Tanzania

Purpose: Despite their increasing use in clinical practice and research in high resource settings, the use of patient reported outcomes (PROs) remains very limited in low resource settings, especially for pediatric cancer patients. PROs provide valuable insight into the patient experience and may better characterize certain symptoms and conditions as compared to provider or lab-based assessments. Therefore, in an effort to expand the use of PROs at our cancer center, Bugando Medical Centre (BMC) located in Mwanza, Tanzania, we endeavored to understand the treatment related toxicities associated with our standard of care treatment for pediatric Burkitt lymphoma (BL). These efforts were intended to both demonstrate the feasibility of using PROs in our setting as well as to inform ongoing research efforts focused on optimizing BL treatment in low resource settings. Methods: Pediatric patients with diagnosis of BL treated in the pediatric oncology department at BMC were offered enrollment in this observational study. Prior to each cycle of chemotherapy, the patient, or their guardian, as age appropriate, was given a Swahili translated and validated Pediatric Patient Reported Outcomes version of the Common Terminology Criteria for Adverse Events (Ped-PRO-CTCAE) survey to complete. Simultaneously, a provider assessment was performed. Results were recorded in a REDCap database. Descriptive statistical analysis was performed in R. Results: 13 patients with BL were enrolled between August and October 2024 and followed for a cumulative total of 34 cycles of cyclophosphamide, vincristine, and methotrexate (COM) chemotherapy as per the 2016 Tanzania National Guidelines. This treatment was overall tolerated well with an average PRO symptom response of <1 (mildly symptomatic) for all queried symptom domains. Provider assessments appeared to trend toward underestimating pain, fatigue, and nausea, as compared to PRO assessments; however, these differences in ratings for these items did not achieve statistical significance. Conclusion: PROs can be meaningfully used in clinical practice for the assessment of tolerance of chemotherapy for pediatric patients in LMICs and may have many practical applications including in clinical trials. In our setting, COM chemotherapy for the treatment of pediatric BL was well tolerated as indicated by low PRO scores. PRO scores may be more sensitive to subjective symptoms such as fatigue, but further investigation is necessary. Citation Format: Hutton Chapman, Jacqueline Kamanga, Heronima Kashaigili, Kristin Schroeder. Use of Patient Reported Outcomes to Assess Treatment Associated Toxicities for Pediatric Burkitt Lymphoma Patients in Tanzania [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 18.