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

Abstract

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 www.clinicaltrials.gov as #NCT00199082.

DOI: 10.1182/blood-2014-03-563627

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@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} }