High response rate and manageable toxicity with an intensive, short-term chemotherapy programme for Burkitt's lymphoma in adults

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Abstract

A very short, intensive paediatric chemotherapy programme was tested in a consecutive monoinstitutional group of 22 adult Burkitt's lymphoma (BL) patients. After a 5-week induction phase of weekly infusions consisting of vincristine, cyclophosphamide, doxorubicin, high-dose (HD) methotrexate (MTX) plus leukovorin rescue, and intrathecal MTX or cytarabine (ARA-C), a consolidation phase including HD ARA-C plus cisplatin was given. Responding patients achieving less than complete response (CR) after completion of the initial induction phase, were promptly shifted to a high-dose, stem cell supported sequential chemotherapy schema (R-HDS). Patient characteristics: median age, 35.5 (range 18-76) years; Ann Arbor stage I-II/ III-IV, 11/11; bulky disease, 15 patients; LDH ≥ 460 U/l, 11 patients. The median duration of the chemotherapy programme was 62 d (range, 43-94 d). Seventeen patients achieved a CR (77%), one patient died of progressive disease and four partial responders following induction were converted to CR following R-HDS. Of 17 patients in CR, one died of infectious toxicity while in CR, and one relapsed at 30 months and died of progressive disease. After a median follow-up of 28-7 months (range, 6-158 months), 16 patients (73%) were in continued CR. Overall survival and progression-free survival were 77% [95% confidence interval (CI), 52-99%] and 68% (95% CI, 43-99%) respectively. Confirmation of these excellent efficacy and feasibility results by larger, multicentre and prospective studies is warranted.

Original languageEnglish
Pages (from-to)815-820
Number of pages6
JournalBritish Journal of Haematology
Volume126
Issue number6
DOIs
Publication statusPublished - Sep 2004

Fingerprint

Burkitt Lymphoma
Drug Therapy
Methotrexate
Confidence Intervals
Leucovorin
Cytarabine
Vincristine
Doxorubicin
Cyclophosphamide
Cisplatin
Multicenter Studies
Disease-Free Survival
Stem Cells
Prospective Studies
Pediatrics
Survival

Keywords

  • Adult Burkitt's lymphoma
  • High-dose chemotherapy
  • Non-Hodgkin's lymphoma
  • Rituximab

ASJC Scopus subject areas

  • Hematology

Cite this

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title = "High response rate and manageable toxicity with an intensive, short-term chemotherapy programme for Burkitt's lymphoma in adults",
abstract = "A very short, intensive paediatric chemotherapy programme was tested in a consecutive monoinstitutional group of 22 adult Burkitt's lymphoma (BL) patients. After a 5-week induction phase of weekly infusions consisting of vincristine, cyclophosphamide, doxorubicin, high-dose (HD) methotrexate (MTX) plus leukovorin rescue, and intrathecal MTX or cytarabine (ARA-C), a consolidation phase including HD ARA-C plus cisplatin was given. Responding patients achieving less than complete response (CR) after completion of the initial induction phase, were promptly shifted to a high-dose, stem cell supported sequential chemotherapy schema (R-HDS). Patient characteristics: median age, 35.5 (range 18-76) years; Ann Arbor stage I-II/ III-IV, 11/11; bulky disease, 15 patients; LDH ≥ 460 U/l, 11 patients. The median duration of the chemotherapy programme was 62 d (range, 43-94 d). Seventeen patients achieved a CR (77{\%}), one patient died of progressive disease and four partial responders following induction were converted to CR following R-HDS. Of 17 patients in CR, one died of infectious toxicity while in CR, and one relapsed at 30 months and died of progressive disease. After a median follow-up of 28-7 months (range, 6-158 months), 16 patients (73{\%}) were in continued CR. Overall survival and progression-free survival were 77{\%} [95{\%} confidence interval (CI), 52-99{\%}] and 68{\%} (95{\%} CI, 43-99{\%}) respectively. Confirmation of these excellent efficacy and feasibility results by larger, multicentre and prospective studies is warranted.",
keywords = "Adult Burkitt's lymphoma, High-dose chemotherapy, Non-Hodgkin's lymphoma, Rituximab",
author = "{Di Nicola}, Massimo and Carmelo Carlo-Stella and Jacopo Mariotti and Liliana Devizzi and Maura Massimino and Antonello Cabras and Michele Magni and Paola Matteucci and Anna Guidetti and Lorenza Gandola and Gianni, {Alessandro M.}",
year = "2004",
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T1 - High response rate and manageable toxicity with an intensive, short-term chemotherapy programme for Burkitt's lymphoma in adults

AU - Di Nicola, Massimo

AU - Carlo-Stella, Carmelo

AU - Mariotti, Jacopo

AU - Devizzi, Liliana

AU - Massimino, Maura

AU - Cabras, Antonello

AU - Magni, Michele

AU - Matteucci, Paola

AU - Guidetti, Anna

AU - Gandola, Lorenza

AU - Gianni, Alessandro M.

PY - 2004/9

Y1 - 2004/9

N2 - A very short, intensive paediatric chemotherapy programme was tested in a consecutive monoinstitutional group of 22 adult Burkitt's lymphoma (BL) patients. After a 5-week induction phase of weekly infusions consisting of vincristine, cyclophosphamide, doxorubicin, high-dose (HD) methotrexate (MTX) plus leukovorin rescue, and intrathecal MTX or cytarabine (ARA-C), a consolidation phase including HD ARA-C plus cisplatin was given. Responding patients achieving less than complete response (CR) after completion of the initial induction phase, were promptly shifted to a high-dose, stem cell supported sequential chemotherapy schema (R-HDS). Patient characteristics: median age, 35.5 (range 18-76) years; Ann Arbor stage I-II/ III-IV, 11/11; bulky disease, 15 patients; LDH ≥ 460 U/l, 11 patients. The median duration of the chemotherapy programme was 62 d (range, 43-94 d). Seventeen patients achieved a CR (77%), one patient died of progressive disease and four partial responders following induction were converted to CR following R-HDS. Of 17 patients in CR, one died of infectious toxicity while in CR, and one relapsed at 30 months and died of progressive disease. After a median follow-up of 28-7 months (range, 6-158 months), 16 patients (73%) were in continued CR. Overall survival and progression-free survival were 77% [95% confidence interval (CI), 52-99%] and 68% (95% CI, 43-99%) respectively. Confirmation of these excellent efficacy and feasibility results by larger, multicentre and prospective studies is warranted.

AB - A very short, intensive paediatric chemotherapy programme was tested in a consecutive monoinstitutional group of 22 adult Burkitt's lymphoma (BL) patients. After a 5-week induction phase of weekly infusions consisting of vincristine, cyclophosphamide, doxorubicin, high-dose (HD) methotrexate (MTX) plus leukovorin rescue, and intrathecal MTX or cytarabine (ARA-C), a consolidation phase including HD ARA-C plus cisplatin was given. Responding patients achieving less than complete response (CR) after completion of the initial induction phase, were promptly shifted to a high-dose, stem cell supported sequential chemotherapy schema (R-HDS). Patient characteristics: median age, 35.5 (range 18-76) years; Ann Arbor stage I-II/ III-IV, 11/11; bulky disease, 15 patients; LDH ≥ 460 U/l, 11 patients. The median duration of the chemotherapy programme was 62 d (range, 43-94 d). Seventeen patients achieved a CR (77%), one patient died of progressive disease and four partial responders following induction were converted to CR following R-HDS. Of 17 patients in CR, one died of infectious toxicity while in CR, and one relapsed at 30 months and died of progressive disease. After a median follow-up of 28-7 months (range, 6-158 months), 16 patients (73%) were in continued CR. Overall survival and progression-free survival were 77% [95% confidence interval (CI), 52-99%] and 68% (95% CI, 43-99%) respectively. Confirmation of these excellent efficacy and feasibility results by larger, multicentre and prospective studies is warranted.

KW - Adult Burkitt's lymphoma

KW - High-dose chemotherapy

KW - Non-Hodgkin's lymphoma

KW - Rituximab

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