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


METHODS
median age, 35.5 (range 18-76) years; Ann Arbor stage I-II/III-IV, 11/11; bulky disease, 15 patients; LDH > or = 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.
Di Nicola
Massimo
M
'Cristina Gandini' Bone Marrow Transplantation Unit, Istituto Nazionale Tumori, Milan, Italy. dinicola@istitutotumori.mi.it
Carlo-Stella
Carmelo
C
Mariotti
Jacopo
J
Devizzi
Liliana
L
Massimino
Maura
M
Cabras
Antonello
A
Magni
Michele
M
Matteucci
Paola
P
Guidetti
Anna
A
Gandola
Lorenza
L
Gianni
Alessandro M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002955:Leucovorin; D008727:Methotrexate