title: Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia.
abstract: BACKGROUND
  Adult Burkitt-type lymphoma (BL) and acute lymphoblastic leukemia (B-ALL) are rare entities composing 1% to 5% of non-Hodgkin lymphomas NHL) or ALL. Prognosis of BL and B-ALL has been poor with conventional NHL or ALL regimens, but has improved with dose-intensive regimens.
  
  
  METHODS
  To evaluate the addition of rituximab, a CD20 monoclonal antibody, to intensive chemotherapy in adults with BL or B-ALL, 31 patients with newly diagnosed BL or B-ALL received the hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen with rituximab. Their median age was 46 years; 29% were 60 years or older. Rituximab 375 mg/m(2) was given on Days 1 and 11 of hyper-CVAD courses and on Days 1 and 8 of methotrexate and cytarabine courses.
  
  
  RESULTS
  Complete remission (complete response [CR]) was achieved in 24 of 28 (86%) evaluable patients; 3 had a partial response, and 1 had resistant disease. There were no induction deaths. The 3-year overall survival (OS), event-free survival, and disease-free survival rates were 89%, 80%, and 88%, respectively. Nine elderly patients achieved CR with all of them in continuous CR (except 1 death in CR from infection), with a 3-year OS rate of 89%. Multivariate analysis of current and historical (those treated with hyper-CVAD alone) groups identified age and treatment with rituximab as favorable factors.
  
  
  CONCLUSIONS
  The addition of rituximab to hyper-CVAD may improve outcome in adult BL or B-ALL, particularly in elderly patients.
authors.affiliation: Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, 77230, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Thomas
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Carlos
authors.initials: C
authors.lastname: Bueso-Ramos
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Giles
authors.forename: Srdan
authors.initials: S
authors.lastname: Verstovsek
authors.forename: William G
authors.initials: WG
authors.lastname: Wierda
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Pierce
authors.forename: Jianqin
authors.initials: J
authors.lastname: Shan
authors.forename: Mark
authors.initials: M
authors.lastname: Brandt
authors.forename: Fredrick B
authors.initials: FB
authors.lastname: Hagemeister
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Keating
authors.forename: Fernando
authors.initials: F
authors.lastname: Cabanillas
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007167:Immunotherapy; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide