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Factors Influencing the Management of Non Hodgkin's Lymphoma in Children at Kenyatta National Hospital

Author: Winnie W. Mwangi , Peter Karimi , Apollo Maima , Charles Githinji , Abdallah Fatumad
Is Part Of: Pharmaceutical Journal of Kenya, Volume 23, No. 1 (2016)
Background: Non-Hodgkin's lymphoma is one of the common childhood cancers. The three main types are lymphoblastic lymphoma, small non cleaved cell lymphoma (Burkitt's and non Burkitt's lymphoma) and largecell lymphoma. Burkitt's lymphoma is the most prevalent.
Objectives: To assess the factors that influence the management of Non-Hodgkin's lymphoma in pediatricpatients during the maintenance phase of therapy at Kenyatta National Hospital.
Methodology: This was a cross-sectional study, involving a universal sample of 19 pediatric patients withNon-Hodgkin’s Lymphoma in the maintenance phase of therapy at Kenyatta National Hospital. Data was collectedthrough interviews and abstraction from patient files andrecorded in a structured questionnaire. Analysis was doneusing descriptive and inferential statistics by employingStatistical Package for Social Sciences version 17.0.
Results: Of the 19 patients, 13(68.4%) were male. The meanage for all the patients was 9.84 years (95% CI: 8.3, 11.3).Eight (42.1%) patients had missed their oral medication.The method of acquisition of oral medication, estimatedexpenditure on medication per month and whether theguardian was counseled on the side effects of themedication, were found to be statistically significant (pvalue 0.037, 0.02 and 0.037 respectively) with adherence.The most prevalent side effects was loss of hair followed bychange in nail/skin pigmentation, dizziness, constipationand tingling sensation of lower extremities. Twelve (63.1%)patients received a cumulative dose of doxorubicin between 200-400mg/m while only 10% had cumulative dose above 400mg/m. Conclusion: The overall adherence to cytotoxic therapywas slightly above average. The reasons for this findingwere high cost and unavailability of the medications as wellas methods of acquisition of the oral medications. Counseling on side effects of the drugs was a significantbarrier to adherence.

Keywords: Non Hodgkin's Lymphoma, Oral chemotherapy, adherence, side effects, cumulative doses
Publisher: The Pharmaceutical Society of Kenya