title: HIV-Associated Burkitt Lymphoma: Good Efficacy and Tolerance of Intensive Chemotherapy Including CODOX-M/IVAC with or without Rituximab in the HAART Era.
abstract: Background. The outcome of HIV-associated non-Hodgkin lymphoma (NHL) has improved substantially in the highly active antiretroviral therapy (HAART) era. However, HIV-Burkitt lymphoma (BL), which accounts for up to 20% of HIV-NHL, has poor outcome with standard chemotherapy. Patients and Methods. We retrospectively reviewed HIV-BL treated in the HAART era with the Magrath regimen (CODOX-M/IVAC±R) at four Canadian centres. Results. Fourteen patients with HIV-BL received at least one CODOX-M/IVAC±R treatment. Median age at BL diagnosis was 45.5 years, CD4 count 375 cells/mL and HIV viral load (VL) <50 copies/mL. Patients received PCP prophylaxis and G-CSF, 13 received HAART with chemotherapy and 10 rituximab. There were 63 episodes of toxicity, none fatal, including: bacterial infection, n = 20; grade 3-4 hematologic toxicity, n = 14; febrile neutropenia, n = 7; oral thrush; and ifosfamide neurological toxicity, n = 1 each. At a median followup of 11.7 months, 12 (86%) patients are alive and in remission. All 10 patients who received HAART, chemotherapy, and rituximab are alive. CD4 counts and HIV VL 6 months following BL therapy completion (n = 5 patients) were >250 cells/mL and undetectable, respectively, in 4. Conclusion. Intensive chemotherapy with CODOX-M/IVAC±R yielded acceptable toxicity and good survival rates in patients with HIV-associated Burkitt lymphoma receiving HAART.
authors.affiliation: Division of Hematology, St. Paul's Hospital and the University of British Columbia, Vancouver, BC, Canada V6T 1Z4.
authors.forename: J A
authors.initials: JA
authors.lastname: Rodrigo
authors.forename: L K
authors.initials: LK
authors.lastname: Hicks
authors.forename: M C
authors.initials: MC
authors.lastname: Cheung
authors.forename: K W
authors.initials: KW
authors.lastname: Song
authors.forename: H
authors.initials: H
authors.lastname: Ezzat
authors.forename: C S
authors.initials: CS
authors.lastname: Leger
authors.forename: J
authors.initials: J
authors.lastname: Boro
authors.forename: J S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: M
authors.initials: M
authors.lastname: Harris
authors.forename: H A
authors.initials: HA
authors.lastname: Leitch