TY - JOUR
T1 - Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia
AU - Kasamon, Yvette L.
AU - Brodsky, Robert A.
AU - Borowitz, Michael J.
AU - Ambinder, Richard F.
AU - Crilley, Pamela A.
AU - Cho, Steve Y.
AU - Tsai, Hua Ling
AU - Smith, B. Douglas
AU - Gladstone, Douglas E.
AU - Carraway, Hetty E.
AU - Huff, Carol Ann
AU - Matsui, William H.
AU - Bolaños-Meade, Javier
AU - Jones, Richard J.
AU - Swinnen, Lode J.
N1 - Funding Information:
Th is work was supported by the National Institutes of Health (K23 CA124465 to Y.L.K., P01 CA015396 to R.J.J.); the National Cancer Institute Lymphoma SPORE (P50 CA09688 to R.F.A.); and philanthropic support of research (to L.J.S.).
PY - 2013/3
Y1 - 2013/3
N2 - Older patients with Burkitt lymphoma/leukemia (BL) have inferior outcomes. Because cyclophosphamide is highly active in BL and can be dose-escalated without stem-cell rescue, we designed a short, cyclophosphamide-intensive regimen without anthracyclines for patients aged ≥ 30 with untreated, non-HIV-associated BL/atypical BL. Two cycles involving cyclophosphamide 1500 mg/m2, vincristine, rituximab, prednisone, methotrexate 3 g/m 2, and intrathecal cytarabine were delivered 2 weeks apart, followed by intensification with high-dose cyclophosphamide (50 mg/kg/day for 4 days) and rituximab. Of 21 patients, median age 53 (range, 34-75), 71% had stage IV, 95% were high-risk and 29% had performance status 3-4. Response occurred in all evaluable patients post-cycle 2 and in 76% post-intensification. Five non-relapse deaths occurred (four before intensification). The estimated 1-year and 3-year event-free survival was 52%; 1-year and 3-year overall survival was 57%. Seventeen (81%) received intensification (median 30 days to intensification). Brief, anthracycline-sparing, intensive cyclophosphamide (BASIC) therapy yields durable remissions in poorer-risk BL/atypical BL.
AB - Older patients with Burkitt lymphoma/leukemia (BL) have inferior outcomes. Because cyclophosphamide is highly active in BL and can be dose-escalated without stem-cell rescue, we designed a short, cyclophosphamide-intensive regimen without anthracyclines for patients aged ≥ 30 with untreated, non-HIV-associated BL/atypical BL. Two cycles involving cyclophosphamide 1500 mg/m2, vincristine, rituximab, prednisone, methotrexate 3 g/m 2, and intrathecal cytarabine were delivered 2 weeks apart, followed by intensification with high-dose cyclophosphamide (50 mg/kg/day for 4 days) and rituximab. Of 21 patients, median age 53 (range, 34-75), 71% had stage IV, 95% were high-risk and 29% had performance status 3-4. Response occurred in all evaluable patients post-cycle 2 and in 76% post-intensification. Five non-relapse deaths occurred (four before intensification). The estimated 1-year and 3-year event-free survival was 52%; 1-year and 3-year overall survival was 57%. Seventeen (81%) received intensification (median 30 days to intensification). Brief, anthracycline-sparing, intensive cyclophosphamide (BASIC) therapy yields durable remissions in poorer-risk BL/atypical BL.
KW - Atypical Burkitt lymphoma
KW - Burkitt lymphoma
KW - Cyclophosphamide
KW - Unclassifiable B-cell lymphoma
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U2 - 10.3109/10428194.2012.715346
DO - 10.3109/10428194.2012.715346
M3 - Article
C2 - 22835045
AN - SCOPUS:84873372346
SN - 1042-8194
VL - 54
SP - 483
EP - 490
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 3
ER -