TITLE:
Rituximab Improves Overall Survival in Patients Treated with CODOX-M/IVAC for Burkitt Lymphoma (BL) and B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and BL (BCL-U): A Single Center Experience and Review of the Literature
AUTHORS:
A. Prica, A. Pratzer, M. Cheung, K. Thompson, E. Piliotis, N. L. Berinstein, K. Imrie, R. Pradhan, A. Vyas, Z. Ghorab, D. Good, L. Zhang, R. Buckstein
KEYWORDS:
Burkitt Lymphoma, Burkitt-Like Lymphoma, CODOX-M/IVAC, MYC, Rituximab
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.6 No.1,
December
26,
2014
ABSTRACT: Background: Dose-modified (dm)
CODOX-M/IVAC is commonly used for Burkitt lymphoma (BL) and B-cell lymphoma,
unclassifiable, with features intermediate between diffuse large B-cell lymphoma
(DLBCL) and BL (BCL-U; previously Burkitt-like lymphoma-BLL). Methods: We
evaluated the clinical characteristics, outcomes and prognostic markers in
patients treated with dmCODOX-M/IVAC+/- rituximab (R) at a single academic
center. Results: 31 patients with BL (n =
21) or BCL-U (n = 10) were included.
The median age was 45, and 90% were high risk. The 2-year overall survival (OS)
and progression-free survival (PFS) were 69% and 62%, respectively, with no differences
between BL and BCL-U. By multivariable analysis, rituximab use was
significantly associated with improved OS (Hazard Ratio 0.15; 95% CI 0.04 - 0.56)
while elevated LDH (Hazard Ratio 2.84, 95% CI 1.52 - 5.29) and rituximab use
(Hazard Ratio 0.054, 95% CI 0.01 - 0.32) predicted PFS. Conclusion:
DmCODOX-M/IVAC+/- R chemotherapy provides equivalent survival for both BL and
BCL-U patients. The addition of rituximab improves overall and progression free
survival and is recommended.