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

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372 Scopus citations

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
Publication statusPublished - Apr 1 2006
Externally publishedYes

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Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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