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Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial.
- Source :
-
Blood [Blood] 2014 Dec 18; Vol. 124 (26), pp. 3870-9. Date of Electronic Publication: 2014 Oct 30. - Publication Year :
- 2014
-
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.<br /> (© 2014 by The American Society of Hematology.)
- Subjects :
- Adolescent
Adrenal Cortex Hormones administration & dosage
Adult
Aged
Aged, 80 and over
Antigens, CD20 immunology
Cyclophosphamide administration & dosage
Cytarabine administration & dosage
Disease-Free Survival
Etoposide administration & dosage
Female
Humans
Ifosfamide administration & dosage
Immunotherapy methods
Injections, Spinal
Male
Methotrexate administration & dosage
Middle Aged
Prognosis
Prospective Studies
Remission Induction
Rituximab
Young Adult
Antibodies, Monoclonal, Murine-Derived administration & dosage
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Burkitt Lymphoma drug therapy
Leukemia drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 124
- Issue :
- 26
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 25359988
- Full Text :
- https://doi.org/10.1182/blood-2014-03-563627