title: Intensive short-term chemotherapy regimen induces high remission rate (over 90%) and event-free survival both in children and adult patients with advanced sporadic Burkitt lymphoma/leukemia.
abstract: The optimal treatment of advanced sporadic Burkitt lymphoma in adults is still a matter of debate. The salutary results of pediatric therapies did open the road for improving the adult outcome. Between May 1988 and March 2009, 71 consecutive patients-46 adults, 25 children-affected by Burkitt lymphoma/leukemia were treated with the same intensive pediatric protocol alternating vincristine, adriamycine and fractionated ciclophosphamide (phase A) with high dose methotrexate and high dose cytarabine (phase B) in four Italian institutions. Eighty-nine per cent of patients were in Stage III-IV or had L3 leukemia. Complete remissions were 67/71 (94.4%), 24/25 (96%) in children, and 43/46 (93.5%) in adults. Toxic deaths were 3/71 (4.2%), all in adults. There were nine relapses (one in children, eight in adults), all but one observed early. After a median observation of 94 months (range 23-275), the Event-Free Survival rate is 92% in children and 71.7% in adults (P = 0.067). The 23 more recent adults received also rituximab, without differences in outcome as compared to patients who did not. Our experience confirms that such an intensive pediatric-derived chemotherapy is feasible and improves the long-term outcome of adults with advanced Burkitt lymphoma.
authors.affiliation: Department of Medicine, Section of Hematology, University of Verona, Italy. giuseppe.todeschini@univr.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Todeschini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bonifacio
authors.forename: Cristina
authors.initials: C
authors.lastname: Tecchio
authors.forename: Rita
authors.initials: R
authors.lastname: Balter
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carli
authors.forename: Piero Maria
authors.initials: PM
authors.lastname: Stefani
authors.forename: Fausto
authors.initials: F
authors.lastname: Adami
authors.forename: Alberto
authors.initials: A
authors.lastname: Zamò
authors.forename: Angelo Paolo
authors.initials: AP
authors.lastname: Dei Tos
authors.forename: Filippo
authors.initials: F
authors.lastname: Marino
authors.forename: Filippo
authors.initials: F
authors.lastname: Gherlinzoni
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Marradi
authors.forename: Giampietro
authors.initials: G
authors.lastname: Semenzato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pizzolo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012074:Remission Induction; D000069283:Rituximab; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab