Abstract
The feasibility and efficacy of up-front high-dose sequential chemotherapy followed by autologous stem cell transplantation (ASCT) in previously untreated adults (median age 33 years; range 15-64) with Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL) or lymphoblastic lymphoma (LyLy), both without central nervous system or extensive bone marrow involvement was investigated in a multicenter phase II study. Treatment consisted of two sequential high-dose chemotherapy induction courses incorporating prednisone, cyclophosphamide, doxorubicin, etoposide and mitoxantrone, without high-dose methotrexate or high-dose cytarabine. Patients with at least PR went on with BEAM and ASCT. Protocol treatment was completed by 23/27 (85%) BL/BLL and 13/15 (87%) LyLy patients. Median treatment duration until BEAM was 70 (range: 50-116) days. No toxic deaths occurred. Response to treatment was complete response (CR) 81% and partial response (PR) 11% for BL/BLL, CR 73% and PR 20% for LyLy. At a median follow-up of 61 months of patients still alive, six BL/BLL and eight LyLy patients have died. The actuarial 5-year overall and event-free survival estimates are 81 and 73% for BL/BLL vs 46 and 40% for LyLy patients. In conclusion, this short up-front high-dose sequential chemotherapy regimen, followed by ASCT is highly effective in adults with BL/BLL with limited bone marrow involvement, but less so in patients with LyLy.
Publication types
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Clinical Trial
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Clinical Trial, Phase II
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Multicenter Study
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Adult
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Antibiotics, Antineoplastic / administration & dosage
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Antibiotics, Antineoplastic / adverse effects
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Antineoplastic Agents, Alkylating / administration & dosage
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Antineoplastic Agents, Alkylating / adverse effects
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Antineoplastic Agents, Phytogenic / administration & dosage
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Antineoplastic Agents, Phytogenic / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Burkitt Lymphoma / drug therapy*
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Burkitt Lymphoma / mortality
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Combined Modality Therapy
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Etoposide / administration & dosage
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Etoposide / adverse effects
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Female
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Follow-Up Studies
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Hematopoietic Stem Cell Transplantation*
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Humans
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Male
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Middle Aged
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Mitoxantrone / administration & dosage
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Mitoxantrone / adverse effects
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Transplantation, Autologous
Substances
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Antibiotics, Antineoplastic
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Antineoplastic Agents, Alkylating
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Antineoplastic Agents, Phytogenic
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Etoposide
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Doxorubicin
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Cyclophosphamide
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Mitoxantrone
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Prednisone