ArticleJCO global oncology2020
Treatment of Hodgkin Lymphoma With ABVD Chemotherapy in Rural Rwanda: A Model for Cancer Care Delivery Implementation.
Article in JCO global oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- Clinicopathologic patterns and treatment outcomes of pediatric classic hodgkin lymphoma in Ethiopian newly opened cancer treatment centers.BMC pediatrics · 2026Article
- Outcome of Classic Hodgkin Lymphoma Treated with ABVD Regimen- A Single Center Experience.Journal of cancer & allied specialties · 2026Article
- Hodgkin lymphoma treatment patterns and outcome disparities in low- and middle-income countries.Blood global hematology · 2025Article
- Childhood cancer survival in low- and middle-income countries and the Global South: emerging evidence and critical gaps from a scoping review of observational studies.EJC paediatric oncology · 2025Review
- Lymphoma in Sub-Saharan Africa: a scoping review of the epidemiology, treatment challenges, and patient pathways.Cancer causes & control : CCC · 2025Article
- Multisector Collaborations and Global Oncology: The Only Way Forward.JCO global oncology · 2021Article
- Cost of Treating Pediatric Cancer at the Butaro Cancer Center of Excellence in Rwanda.Journal of global oncology · 2018Article
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
purposeHodgkin lymphoma (HL) is highly curable in high-income countries (HICs), yet many patients around the world do not have access to therapy. In 2012, cancer care was established at a rural district hospital in Rwanda through international collaboration, and a treatment protocol using doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) without radiotherapy was implemented.
methodsWe conducted a retrospective cohort study of all patients with confirmed HL seen at Butaro Hospital from 2012 to 2018 to evaluate quality indicators and clinical outcomes.
resultsEighty-five patients were included (median age, 16.8 years; interquartile range, 11.0-30.5 years). Ten (12%) were HIV positive. Most had B symptoms (70%) and advanced stage (56%) on examination and limited imaging. Of 21 specimens evaluated for Epstein-Barr virus, 14 (67%) were positive. Median time from biopsy to treatment was 6.0 weeks. Of 73 patients who started ABVD, 54 (74%) completed 6 cycles; the leading reasons for discontinuation were treatment abandonment and death. Median dose intensity of ABVD was 92%. Of 77 evaluable patients, 33 (43%) are in clinical remission, 27 (36%) are deceased, and 17 (22%) were lost to follow-up; 3-year survival estimate is 63% (95% CI, 50% to 74%). Poorer performance status, advanced stage, B symptoms, anemia, dose intensity < 85%, and treatment discontinuation were associated with worse survival.
conclusionTreating HL with standard chemotherapy in a low-resource setting is feasible. Most patients who completed treatment experienced a clinically significant remission with this approach. Late presentation, treatment abandonment, and loss to follow-up contribute to the discrepancy in survival compared with HICs. A strikingly younger age distribution in our cohort compared with HICs suggests biologic differences and warrants further investigation.
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