Lack of influence of human immunodeficiency virus infection status in the response to therapy and survival of adult patients with mature B-cell lymphoma or leukemia. Results of the PETHEMA-LAL3/97 study.
OBJECTIVE
Short, intensive multiagent chemotherapy has resulted in significant progress in Burkitt's lymphoma and leukemia. A protocol was designed to treat all adult patients with mature B-cell lymphoma or leukemia with the aims of comparing the response to therapy and survival with regards to their HIV infection status.


METHODS
Fifty-three adult patients with advanced stage Burkitt's lymphoma or Burkitt's leukemia were treated. Response to therapy, survival and toxicity were evaluated according to their HIV infection status.


RESULTS
The median age of the patients was 53 years (range 15-74). There were no differences in CR rates between HIV-negative (77%) and HIV-positive patients (71%). Only age > 60 years was associated with a lower CR rate (OR 0.18, 95%CI 0.04-0.81, p=0.026). The 2-year overall survival (OS) probability was 51% (95%CI, 38%-64%) for the 53 patients. The OS of HIV-negative and HIV-positive patients did not significantly differ. Only age > 60 years was associated with a shorter OS (OR 5.1, 95%CI 2.0-12.7, p=0.001). The 2-year disease free survival (DFS) for the 40 patients achieving CR was 60% (95%CI, 45%-75%). Age > 60 years was the only identified factor associated with a shorter DFS (OR 5.2, 95%CI 1.4-20, p=0.015).


CONCLUSIONS
This study confirms the effectiveness of intensive strategies in adult patients with advanced stage Burkitt's lymphoma or leukemia. It also shows the feasibility of these strategies in individuals with HIV infection with comparable results. Advanced age proved to be the main adverse prognostic factor for response to therapy and survival.
Oriol
Albert
A
Servei d'Hematologia, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
Ribera
Josep-Maria
JM
Esteve
Jordi
J
Sanz
Miguel-Angel
MA
Brunet
Salut
S
Garcia-Boyero
Raimundo
R
Fernández-Abellán
Pascual
P
Martí
Josep-Maria
JM
Abella
Eugènia
E
Sánchez-Delgado
Magdalena
M
Peñarrubia
Maria-Jesús
MJ
Besalduch
Joan
J
Moreno
Maria-José
MJ
Borrego
Domingo
D
Feliu
Evarist
E
Ortega
Juan-José
JJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity; D002051:Burkitt Lymphoma / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome