Abstract
Children and adolescents with Burkitt Lymphoma (BL) and combined central nervous system (CNS) and bone marrow involvement still have a poor prognosis with chemotherapy alone. We therefore investigated in children and adolescents with bone marrow (≥25% blasts) and/or CNS-positive Burkitt lymphoma the chemoimmunotherapy combination of rituximab (375 mg/m(2) ) and the standard chemotherapy arm of our previously reported French-American-British (FAB) Lymphome Malins de Burkitt (LMB) 96 trial. Central pathological and cytogenetic characterization was also performed. There were 40 evaluable patients with Burkitt histology (25 with leukaemia and 15 with CNS disease ± leukaemia). The chemoimmunotherapy regimen was well tolerated. The incidence of grade III/IV mucositis during induction cycles with combined chemotherapy and rituximab was 31% and 26%, respectively. The 3-year event-free survival (EFS)/overall survival (OS) was 90% (95% confidence interval [CI], 76-96%) in the entire cohort and 93% (95% CI, 61-99%) in patients with CNS disease. Based on the results of this trial, an international randomized study of FAB/LMB 96 chemotherapy ± rituximab for high-risk patients is currently under investigation.
Keywords:
Burkitt leukaemia; Burkitt lymphoma; chemotherapy; children; rituximab.
© 2014 John Wiley & Sons Ltd.
Publication types
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Clinical Trial
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Multicenter Study
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Antibodies, Monoclonal, Murine-Derived / administration & dosage
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Antibodies, Monoclonal, Murine-Derived / 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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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Bone Marrow / pathology
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Burkitt Lymphoma / drug therapy*
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Burkitt Lymphoma / genetics
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Central Nervous System Neoplasms / drug therapy*
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Child
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Consolidation Chemotherapy
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Cytarabine / administration & dosage
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Cytarabine / adverse effects
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Disease-Free Survival
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Drug Administration Schedule
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Etoposide / administration & dosage
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Etoposide / adverse effects
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Female
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Genes, myc
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Humans
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Immunotherapy
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Infusions, Intravenous
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Kaplan-Meier Estimate
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Lymphoma, B-Cell / drug therapy*
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Lymphoma, B-Cell / genetics
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Maintenance Chemotherapy
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Male
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Methotrexate / administration & dosage
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Methotrexate / adverse effects
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Remission Induction
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Rituximab
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Typhlitis / chemically induced
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Vincristine / administration & dosage
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Vincristine / adverse effects
Substances
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Antibodies, Monoclonal, Murine-Derived
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Cytarabine
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Rituximab
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Vincristine
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Etoposide
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Doxorubicin
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Cyclophosphamide
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Prednisone
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Methotrexate
Supplementary concepts
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CHOP protocol
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COP protocol 2