title: High cure rates in Burkitt lymphoma and leukemia: a Northern Italy Leukemia Group study of the German short intensive rituximab-chemotherapy program.
abstract: We evaluate the long-term results of a prospective clinical study enrolling more than 100 adult patients with Burkitt lymphoma/leukemia. Depending on extent of disease, treatment consisted of six to eight rituximab infusions and four to six courses of intensive chemotherapy (attenuated in patients aged >55 years) with high-dose methotrexate, fractionated ifosfamide/cyclophosphamide, other drugs in rotation, and intrathecal chemoprophylaxis. One-hundred five patients were treated (median age 47 years, range 17-78 years); 48% had Burkitt leukemia, 25% were older than 60 years, 37% had an Eastern Cooperative Oncology Group performance score >1, and 14% were positive for human immunodeficiency virus. The complete response rate and 3-year overall and disease-free survival rates were 79%, 67% and 75%, respectively, ranging from 100% to 45% for survival (P=0.000) and from 100% to 60% for disease-free survival (P=0.01) in patients with low, intermediate and high adapted International Prognostic Index scores. In multivariate analysis, only age (≤ versus >60 years) and performance status (0-1 versus >1) retained prognostic significance, identifying three risk groups with overall and disease-free survival probabilities of 88% and 87.5%, 57% and 70.5%, 20% and 28.5% (P=0.0000 and P=0.0001), respectively. The relapse rate was only 7% in patients treated with an intercycle interval ≤ 25 days. This regimen achieved 100% curability in patients with low adapted International Prognostic Index scores (21% of total), and very close to 90% in patients aged ≤ 60 years with performance score 0-1 (48% of total). Rapid diagnosis of Burkitt lymphoma/leukemia with prompt referral of patients to prevent clinical deterioration, and careful supervision of treatment without chemotherapy delay can achieve outstanding therapeutic results. ClinicalTrials.gov ID, NCT01290120.
authors.affiliation: renato.bassan@ulss12.ve.it.
authors.forename: Tamara
authors.initials: T
authors.lastname: Intermesoli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Federica
authors.initials: F
authors.lastname: Delaini
authors.forename: Claudio
authors.initials: C
authors.lastname: Romani
authors.forename: Enrico Maria
authors.initials: EM
authors.lastname: Pogliani
authors.forename: Chiara
authors.initials: C
authors.lastname: Pagani
authors.forename: Emanuele
authors.initials: E
authors.lastname: Angelucci
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Terruzzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Levis
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cassibba
authors.forename: Daniele
authors.initials: D
authors.lastname: Mattei
authors.forename: Giacomo
authors.initials: G
authors.lastname: Gianfaldoni
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Scattolin
authors.forename: Eros
authors.initials: E
authors.lastname: Di Bona
authors.forename: Elena
authors.initials: E
authors.lastname: Oldani
authors.forename: Margherita
authors.initials: M
authors.lastname: Parolini
authors.forename: Nicola
authors.initials: N
authors.lastname: Gökbuget
authors.forename: Renato
authors.initials: R
authors.lastname: Bassan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007938:Leukemia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D000069283:Rituximab; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab