Participants
We implemented the Chichewa Pediatric PROMIS-25 measure to assess HRQoL
of patients aged 5-18 years with lymphoma who were diagnosed at KCH
between June 2016 and September 2018. All patients were enrolled in the
KCH Lymphoma study, an observational prospective cohort study that began
in 2013, and were followed for two years after treatment
completion.2,22,23
Patients were staged using physical examination, chest radiography,
abdominal ultrasound, unilateral bone marrow biopsy, and cerebrospinal
fluid cytology, as previously described.2,22 The
clinician-reported Lansky performance score (LPS), routinely used in
cancer clinical trials for children <16 years, was obtained at
diagnosis.24 All lymphoma diagnoses were
pathologically confirmed using tissue biopsies and immunohistochemistry
and were interpreted during real-time weekly telepathology
conferences.21
Standard chemotherapy regimens were administered and evolved during the
study period, and as previously described: Hodgkin lymphoma patients
received ABVE-PC regimen (doxorubicin, bleomycin, vincristine, etoposide
– prednisone & cyclophosphamide); low-risk Burkitt Lymphoma patients
received COMP (cyclophosphamide, vincristine, methotrexate and
prednisone); and high-risk Burkitt lymphoma initially received CHOP
(cyclophosphamide, doxorubicin, vincristine, prednisone) and more
recently received modified COPADM (cyclophosphamide, vincristine,
prednisone, doxorubicin, methotrexate).2,22,23Radiotherapy is not available in Malawi.