title: Dose-intensive chemotherapy including rituximab is highly effective but toxic in human immunodeficiency virus-infected patients with Burkitt lymphoma/leukemia: parallel study of 81 patients.
abstract: The results of intensive immunochemotherapy were analyzed in human immunodeficiency virus (HIV)-related Burkitt lymphoma/leukemia (BLL) in two cohorts (Spain and Germany). Alternating cycles of chemotherapy were administered, with dose reductions for patients over 55 years. Eighty percent of patients achieved remission, 11% died during induction, 9% failed and 7% died in remission. Four-year overall survival (OS) and progression-free survival (PFS) probabilities were 72% (95% confidence interval [CI]: 62-82%) and 71% (95% CI: 61-81%). CD4 T-cell count < 200/μL and bone marrow involvement were associated with poor OS (hazard ratio [HR] 3.2 [1.2-8.3] and HR 2.7 [1.1-6.6]) and PFS (HR 3.5 [1.3-9.1] and HR 2.4 [1-5.7]), bone marrow involvement with poor disease-free survival (DFS) (HR 14.4 [1.7-119.7] and Eastern Cooperative Oncology Group (ECOG) score > 2 (odds ratio [OR] 11.9 [1.4-99.9]) with induction death. In HIV-related BLL, intensive immunochemotherapy was feasible and effective, but toxic. Prognostic factors were performance status, CD4 T-cell count and bone marrow involvement.
authors.affiliation: Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Institut de Recerca Contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona , Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Xicoy
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Ribera
authors.forename: Markus
authors.initials: M
authors.lastname: Müller
authors.forename: Olga
authors.initials: O
authors.lastname: García
authors.forename: Christian
authors.initials: C
authors.lastname: Hoffmann
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Marcus
authors.initials: M
authors.lastname: Hentrich
authors.forename: Carlos
authors.initials: C
authors.lastname: Grande
authors.forename: Jan-Christian
authors.initials: JC
authors.lastname: Wasmuth
authors.forename: Jordi
authors.initials: J
authors.lastname: Esteve
authors.forename: Jan
authors.initials: J
authors.lastname: van Lunzen
authors.forename: Eloy
authors.initials: E
authors.lastname: Del Potro
authors.forename: Heribert
authors.initials: H
authors.lastname: Knechten
authors.forename: Salut
authors.initials: S
authors.lastname: Brunet
authors.forename: Christoph
authors.initials: C
authors.lastname: Mayr
authors.forename: Lourdes
authors.initials: L
authors.lastname: Escoda
authors.forename: Philipp
authors.initials: P
authors.lastname: Schommers
authors.forename: Natalia
authors.initials: N
authors.lastname: Alonso
authors.forename: Ferran
authors.initials: F
authors.lastname: Vall-Llovera
authors.forename: Montserrat
authors.initials: M
authors.lastname: Pérez
authors.forename: Mireia
authors.initials: M
authors.lastname: Morgades
authors.forename: José
authors.initials: J
authors.lastname: González
authors.forename: Angeles
authors.initials: A
authors.lastname: Fernández
authors.forename: Jan
authors.initials: J
authors.lastname: Thoden
authors.forename: Nicola
authors.initials: N
authors.lastname: Gökbuget
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoelzer
authors.forename: Gerd
authors.initials: G
authors.lastname: Fätkenheuer
authors.forename: Christoph
authors.initials: C
authors.lastname: Wyen
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002051:Burkitt Lymphoma / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005858:Germany; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D000069283:Rituximab; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab
keywords: Burkitt lymphoma or leukemia; HIV infection; Specific chemotherapy; prognostic factors