Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia

Yvette L. Kasamon, Robert A Brodsky, Michael J Borowitz, Richard F Ambinder, Pamela A. Crilley, Steve Y. Cho, Hua Ling Tsai, B Douglas Smith, Douglas Gladstone, Hetty E. Carraway, Carol Ann Huff, William H. Matsui, F Javier Bolanos Meade, Richard J Jones, Lode Swinnen

Research output: Contribution to journalArticle

Abstract

Older patients with Burkitt lymphoma/leukemia (BL) have inferior outcomes. Because cyclophosphamide is highly active in BL and can be dose-escalated without stem-cell rescue, we designed a short, cyclophosphamide-intensive regimen without anthracyclines for patients aged ≥ 30 with untreated, non-HIV-associated BL/atypical BL. Two cycles involving cyclophosphamide 1500 mg/m2, vincristine, rituximab, prednisone, methotrexate 3 g/m 2, and intrathecal cytarabine were delivered 2 weeks apart, followed by intensification with high-dose cyclophosphamide (50 mg/kg/day for 4 days) and rituximab. Of 21 patients, median age 53 (range, 34-75), 71% had stage IV, 95% were high-risk and 29% had performance status 3-4. Response occurred in all evaluable patients post-cycle 2 and in 76% post-intensification. Five non-relapse deaths occurred (four before intensification). The estimated 1-year and 3-year event-free survival was 52%; 1-year and 3-year overall survival was 57%. Seventeen (81%) received intensification (median 30 days to intensification). Brief, anthracycline-sparing, intensive cyclophosphamide (BASIC) therapy yields durable remissions in poorer-risk BL/atypical BL.

Original languageEnglish (US)
Pages (from-to)483-490
Number of pages8
JournalLeukemia and Lymphoma
Volume54
Issue number3
DOIs
Publication statusPublished - Mar 2013

    Fingerprint

Keywords

  • Atypical Burkitt lymphoma
  • Burkitt lymphoma
  • Cyclophosphamide
  • Unclassifiable B-cell lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this