Burkitt lymphoma - no impact of HIV status on outcomes with rituximab-based chemoimmunotherapy

Leuk Lymphoma. 2023 Mar;64(3):586-596. doi: 10.1080/10428194.2022.2027402. Epub 2022 Feb 19.

Abstract

We analyzed the prognostic factors for treatment outcomes amongst 34 patients with adult Burkitt lymphoma (BL) who received rituximab with standard first-line chemotherapy. Seven patients had human immunodeficiency virus (HIV)-associated BL. Overall, we observed a complete remission (CR) rate of 91.2%, and 10-year progression-free survival (PFS) and overall survival (OS) was 84.8 and 88.2%, respectively. In patients with concomitant HIV, the prognosis was not different with 10-year PFS of 100% and OS of 88.2%. The majority (71.4%) of HIV-associated BL patients received dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) and had excellent outcomes with 100% CR and no relapses. Central nervous system (CNS) disease, bone marrow involvement and elevated serum lactate dehydrogenase (LDH) levels more than 3 times upper limit of normal (ULN) were associated with poorer survival outcomes. Patients with refractory disease, whilst uncommon (n = 4), had dismal outcomes. Patients with adult BL, including HIV-related cases, harbor generally good prognosis in the modern era.

Keywords: Burkitt lymphoma; bone marrow; central nervous system; human immunodeficiency virus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burkitt Lymphoma* / diagnosis
  • Burkitt Lymphoma* / drug therapy
  • Cyclophosphamide
  • Doxorubicin / adverse effects
  • HIV Infections* / complications
  • HIV Infections* / drug therapy
  • Humans
  • Methotrexate / therapeutic use
  • Neoplasm Recurrence, Local / drug therapy
  • Rituximab
  • Vincristine / adverse effects

Substances

  • Rituximab
  • Methotrexate
  • Cyclophosphamide
  • Vincristine
  • Doxorubicin