Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial.


This largest prospective multicenter trial for adult patients with Burkitt lymphoma/leukemia aimed to prove the efficacy and feasibility of short-intensive chemotherapy combined with the anti-CD20 antibody rituximab. From 2002 to 2011, 363 patients 16 to 85 years old were recruited in 98 centers. Treatment consisted of 6 5-day chemotherapy cycles with high-dose methotrexate, high-dose cytosine arabinoside, cyclophosphamide, etoposide, ifosphamide, corticosteroids, and triple intrathecal therapy. Patients >55 years old received a reduced regimen. Rituximab was given before each cycle and twice as maintenance, for a total of 8 doses. The rate of complete remission was 88% (319/363); overall survival (OS) at 5 years, 80%; and progression-free survival, 71%; with significant difference between adolescents, adults, and elderly patients (OS rate of 90%, 84%, and 62%, respectively). Full treatment could be applied in 86% of the patients. The most important prognostic factors were International Prognostic Index (IPI) score (0-2 vs 3-5; P = .0005), age-adjusted IPI score (0-1 vs 2-3; P = .0001), and gender (male vs female; P = .004). The high cure rate in this prospective trial with a substantial number of participating hospitals demonstrates the efficacy and feasibility of chemoimmunotherapy, even in elderly patients. This trial was registered at as #NCT00199082.

DOI: 10.1182/blood-2014-03-563627

10 Figures and Tables

Citations per Year

303 Citations

Semantic Scholar estimates that this publication has 303 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Hoelzer2014ImprovedOO, title={Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial.}, author={Dieter Hoelzer and Jan Walewski and Hartmut D{\"{o}hner and Andreas Viardot and Wolfgang Hiddemann and Karsten Spiekermann and Hubert Serve and Ulrich D{\"{u}hrsen and Andreas H{\"{u}ttmann and Eckhard Thiel and Jolanta Dengler and Michael Kneba and Markus Schaich and Ingo G H Schmidt-Wolf and Joachim Beck and Bernd Hertenstein and Albrecht Reichle and Katarzyna Domanska-Czyz and Rainer Fietkau and Heinz-August Horst and Harald Rieder and Stefan Schwartz and Thomas Burmeister and Nicola G{\"{o}kbuget}, journal={Blood}, year={2014}, volume={124 26}, pages={3870-9} }