Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia

Deborah A. Thomas, Stefan Faderl, Susan O'Brien, Carlos Bueso-Ramos, Jorge Cortes, Guillermo Garcia-Manero, Francis J. Giles, Srdan Verstovsek, William G. Wierda, Sherry A. Pierce, Jianqin Shan, Mark Brandt, Fredrick B. Hagemeister, Michael J. Keating, Fernando Cabanillas, Hagop Kantarjian

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Adult Burkitt-type lymphoma (BL) and acute lymphoblastic leukemia (B-ALL) are rare entities composing 1% to 5% of non-Hodgkin lymphomas NHL) or ALL. Prognosis of BL and B-ALL has been poor with conventional NHL or ALL regimens, but has improved with dose-intensive regimens. METHODS. To evaluate the addition of rituximab, a CD20 monoclonal antibody, to intensive chemotherapy in adults with BL or B-ALL, 31 patients with newly diagnosed BL or B-ALL received the hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen with rituximab. Their median age was 46 years; 29% were 60 years or older. Rituximab 375 mg/m2 was given on Days 1 and 11 of hyper-CVAD courses and on Days 1 and 8 of methotrexate and cytarabine courses. RESULTS. Complete remission (complete response [CR]) was achieved in 24 of 28 (86%) evaluable patients; 3 had a partial response, and 1 had resistant disease. There were no induction deaths. The 3-year overall survival (OS), event-free survival, and disease-free survival rates were 89%, 80%, and 88%, respectively. Nine elderly patients achieved CR with all of them in continuous CR (except 1 death in CR from infection), with a 3-year OS rate of 89%. Multivariate analysis of current and historical (those treated with hyper-CVAD alone) groups identified age and treatment with rituximab as favorable factors. CONCLUSIONS. The addition of rituximab to hyper-CVAD may improve outcome in adult BL or B-ALL, particularly in elderly patients.

Original languageEnglish (US)
Pages (from-to)1569-1580
Number of pages12
JournalCancer
Volume106
Issue number7
DOIs
StatePublished - Apr 1 2006
Externally publishedYes

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Burkitt Lymphoma
Vincristine
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Doxorubicin
Cyclophosphamide
Dexamethasone
Disease-Free Survival
Survival Rate
Therapeutics
Cytarabine
Methotrexate
Non-Hodgkin's Lymphoma
Multivariate Analysis
Age Groups
Monoclonal Antibodies
Rituximab
Drug Therapy
Survival
Infection

Keywords

  • Acute lymphoblastic leukemia
  • Adult Burkitt lymphoma
  • B-ALL
  • BL
  • Chemoimmunotherapy
  • Hyper-CVAD
  • Rituximab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. / Thomas, Deborah A.; Faderl, Stefan; O'Brien, Susan; Bueso-Ramos, Carlos; Cortes, Jorge; Garcia-Manero, Guillermo; Giles, Francis J.; Verstovsek, Srdan; Wierda, William G.; Pierce, Sherry A.; Shan, Jianqin; Brandt, Mark; Hagemeister, Fredrick B.; Keating, Michael J.; Cabanillas, Fernando; Kantarjian, Hagop.

In: Cancer, Vol. 106, No. 7, 01.04.2006, p. 1569-1580.

Research output: Contribution to journalArticle

Thomas, DA, Faderl, S, O'Brien, S, Bueso-Ramos, C, Cortes, J, Garcia-Manero, G, Giles, FJ, Verstovsek, S, Wierda, WG, Pierce, SA, Shan, J, Brandt, M, Hagemeister, FB, Keating, MJ, Cabanillas, F & Kantarjian, H 2006, 'Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia', Cancer, vol. 106, no. 7, pp. 1569-1580. https://doi.org/10.1002/cncr.21776
Thomas, Deborah A. ; Faderl, Stefan ; O'Brien, Susan ; Bueso-Ramos, Carlos ; Cortes, Jorge ; Garcia-Manero, Guillermo ; Giles, Francis J. ; Verstovsek, Srdan ; Wierda, William G. ; Pierce, Sherry A. ; Shan, Jianqin ; Brandt, Mark ; Hagemeister, Fredrick B. ; Keating, Michael J. ; Cabanillas, Fernando ; Kantarjian, Hagop. / Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. In: Cancer. 2006 ; Vol. 106, No. 7. pp. 1569-1580.
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abstract = "BACKGROUND. Adult Burkitt-type lymphoma (BL) and acute lymphoblastic leukemia (B-ALL) are rare entities composing 1{\%} to 5{\%} of non-Hodgkin lymphomas NHL) or ALL. Prognosis of BL and B-ALL has been poor with conventional NHL or ALL regimens, but has improved with dose-intensive regimens. METHODS. To evaluate the addition of rituximab, a CD20 monoclonal antibody, to intensive chemotherapy in adults with BL or B-ALL, 31 patients with newly diagnosed BL or B-ALL received the hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen with rituximab. Their median age was 46 years; 29{\%} were 60 years or older. Rituximab 375 mg/m2 was given on Days 1 and 11 of hyper-CVAD courses and on Days 1 and 8 of methotrexate and cytarabine courses. RESULTS. Complete remission (complete response [CR]) was achieved in 24 of 28 (86{\%}) evaluable patients; 3 had a partial response, and 1 had resistant disease. There were no induction deaths. The 3-year overall survival (OS), event-free survival, and disease-free survival rates were 89{\%}, 80{\%}, and 88{\%}, respectively. Nine elderly patients achieved CR with all of them in continuous CR (except 1 death in CR from infection), with a 3-year OS rate of 89{\%}. Multivariate analysis of current and historical (those treated with hyper-CVAD alone) groups identified age and treatment with rituximab as favorable factors. CONCLUSIONS. The addition of rituximab to hyper-CVAD may improve outcome in adult BL or B-ALL, particularly in elderly patients.",
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T1 - Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia

AU - Thomas, Deborah A.

AU - Faderl, Stefan

AU - O'Brien, Susan

AU - Bueso-Ramos, Carlos

AU - Cortes, Jorge

AU - Garcia-Manero, Guillermo

AU - Giles, Francis J.

AU - Verstovsek, Srdan

AU - Wierda, William G.

AU - Pierce, Sherry A.

AU - Shan, Jianqin

AU - Brandt, Mark

AU - Hagemeister, Fredrick B.

AU - Keating, Michael J.

AU - Cabanillas, Fernando

AU - Kantarjian, Hagop

PY - 2006/4/1

Y1 - 2006/4/1

N2 - BACKGROUND. Adult Burkitt-type lymphoma (BL) and acute lymphoblastic leukemia (B-ALL) are rare entities composing 1% to 5% of non-Hodgkin lymphomas NHL) or ALL. Prognosis of BL and B-ALL has been poor with conventional NHL or ALL regimens, but has improved with dose-intensive regimens. METHODS. To evaluate the addition of rituximab, a CD20 monoclonal antibody, to intensive chemotherapy in adults with BL or B-ALL, 31 patients with newly diagnosed BL or B-ALL received the hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen with rituximab. Their median age was 46 years; 29% were 60 years or older. Rituximab 375 mg/m2 was given on Days 1 and 11 of hyper-CVAD courses and on Days 1 and 8 of methotrexate and cytarabine courses. RESULTS. Complete remission (complete response [CR]) was achieved in 24 of 28 (86%) evaluable patients; 3 had a partial response, and 1 had resistant disease. There were no induction deaths. The 3-year overall survival (OS), event-free survival, and disease-free survival rates were 89%, 80%, and 88%, respectively. Nine elderly patients achieved CR with all of them in continuous CR (except 1 death in CR from infection), with a 3-year OS rate of 89%. Multivariate analysis of current and historical (those treated with hyper-CVAD alone) groups identified age and treatment with rituximab as favorable factors. CONCLUSIONS. The addition of rituximab to hyper-CVAD may improve outcome in adult BL or B-ALL, particularly in elderly patients.

AB - BACKGROUND. Adult Burkitt-type lymphoma (BL) and acute lymphoblastic leukemia (B-ALL) are rare entities composing 1% to 5% of non-Hodgkin lymphomas NHL) or ALL. Prognosis of BL and B-ALL has been poor with conventional NHL or ALL regimens, but has improved with dose-intensive regimens. METHODS. To evaluate the addition of rituximab, a CD20 monoclonal antibody, to intensive chemotherapy in adults with BL or B-ALL, 31 patients with newly diagnosed BL or B-ALL received the hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) regimen with rituximab. Their median age was 46 years; 29% were 60 years or older. Rituximab 375 mg/m2 was given on Days 1 and 11 of hyper-CVAD courses and on Days 1 and 8 of methotrexate and cytarabine courses. RESULTS. Complete remission (complete response [CR]) was achieved in 24 of 28 (86%) evaluable patients; 3 had a partial response, and 1 had resistant disease. There were no induction deaths. The 3-year overall survival (OS), event-free survival, and disease-free survival rates were 89%, 80%, and 88%, respectively. Nine elderly patients achieved CR with all of them in continuous CR (except 1 death in CR from infection), with a 3-year OS rate of 89%. Multivariate analysis of current and historical (those treated with hyper-CVAD alone) groups identified age and treatment with rituximab as favorable factors. CONCLUSIONS. The addition of rituximab to hyper-CVAD may improve outcome in adult BL or B-ALL, particularly in elderly patients.

KW - Acute lymphoblastic leukemia

KW - Adult Burkitt lymphoma

KW - B-ALL

KW - BL

KW - Chemoimmunotherapy

KW - Hyper-CVAD

KW - Rituximab

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