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Feasibility and outcomes after dose reduction of immunochemotherapy in young adults with Burkitt lymphoma and leukemia: results of the BURKIMAB14 trial.

Authors
  • Ribera, Josep-Maria1
  • Morgades, Mireia2
  • Garcia-Calduch, Olga2
  • Sirvent, Maialen3
  • Buendia, Buenaventura4
  • Cervera, Marta5
  • Luzardo, Hugo6
  • Hernandez-Rivas, Jesus-Maria7
  • Sitges, Marta8
  • Garcia-Cadenas, Irene9
  • Abrisqueta, Pau10
  • Montesinos, Pau11
  • Bastos-Oreiro, Mariana12
  • De Llano, Maria-Paz Queipo13
  • Bravo, Pilar14
  • Torrent, Anna2
  • Herrera, Pilar15
  • Garcia-Guinon, Antoni16
  • Vall-Llovera, Ferran17
  • Serrano, Josefina18
  • And 10 more
  • 1 Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona. [email protected].
  • 2 Institut Catala d'Oncologia-Hospital Germans Trias i Pujol. Josep Carreras Research Institute-Badalona. Universitat Autonoma de Barcelona.
  • 3 Hospital Universitario de Donostia. Donostia.
  • 4 Hospital Universitario 12 de Octubre. Madrid.
  • 5 Institut Catala d'Oncologia-Hospital Joan XXIII. Tarragona.
  • 6 Hospital Universitario de Gran Canaria Dr. Negrin. Las Palmas de Gran Canaria.
  • 7 IBSAL, IBMCC, Centro de Investigacion del Cancer, CIBERONC, Universidad de Salamanca-CSIC, Hospital Universitario de Salamanca. Salamanca.
  • 8 Institut Catala d'Oncologia-Hospital Josep Trueta. Girona.
  • 9 Hospital de la Santa Creu i Sant Pau. Barcelona.
  • 10 Hospital Universitari Vall d'Hebron. Barcelona.
  • 11 Hospital Universitari i Politecnic La Fe. Valencia.
  • 12 Hospital General Universitario Gregorio Maranon, IiSGM. Madrid.
  • 13 Hospital Universitario Virgen de la Victoria. Malaga.
  • 14 Hospital Universitario de Fuenlabrada. Madrid.
  • 15 Hospital Universitario Ramon y Cajal. Madrid.
  • 16 Hospital Universitari Arnau de Vilanova de Lleida. Lleida.
  • 17 Hospital Universitari Mutua de Terrassa. Terrassa.
  • 18 Hospital Universitario Reina Sofia. IMIBIC. Cordoba.
  • 19 Hospital Clinico Universitario de Valencia. Valencia.
  • 20 Hospital San Pedro de Alcantara. Caceres.
  • 21 Hospital Universitario de La Princesa. Madrid.
  • 22 Hospital Universitario Basurto. Bilbao.
  • 23 Hospital Universitario HM Sanchinarro. Madrid. , (China)
  • 24 Hospital Universitario La Zarzuela. Madrid.
  • 25 Hospital del Mar. Barcelona.
  • 26 Hospital Universitari Son Llatzer. Palma de Mallorca.
  • 27 Institut Catala d'Oncologia-Hospital Duran i Reynals. L'Hospitalet de Llobregat.
Type
Published Article
Journal
Haematologica
Publisher
Ferrata Storti Foundation
Publication Date
Feb 01, 2024
Volume
109
Issue
2
Pages
543–552
Identifiers
DOI: 10.3324/haematol.2023.283342
PMID: 37560813
Source
Medline
Language
English
License
Unknown

Abstract

High dose-intensive or infusional intermediate-dose immunochemotherapy is highly effective treatment for Burkitt lymphoma irrespective of human immunodeficiency virus (HIV) infection. However, toxicities of these regimens are relevant, especially in older adults and elderly patients. The prospective multicenter BURKIMAB14 trial included four to six blocks of immunochemotherapy according to stage (localized: 1 and 2 non-bulky; advanced: 2 bulky, 3, 4) and age, with dose reduction in patients >55 years old. Dose-intensity of chemotherapy was reduced in patients ≤55 years old after achieving complete metabolic response (CMR). Their outcomes were compared with those of similar patients included in the former BURKIMAB08 trial, in which there was no dose reduction. CMR was attained in 86 of 107 (80%) patients (17/19 in localized stages and 69/88 in advanced stages). Patients from the BURKIMAB14 trial ≤55 years old showed similar overall survival (OS), fewer infections and cytopenias than patients from the BURKIMAB08 trial. Patients >55 years old had a significantly higher treatment- related mortality despite dose reduction of chemotherapy. With a median follow-up of 3.61 years the 4-year OS probability was 73% (range, 63-81%). Age (≤55 vs. >55 years) and stage (localized vs. advanced) had prognostic significance. No significant differences in OS were observed in HIV-positive versus HIV-negative patients. The results of BURKIMAB14 are similar to those of other dose-intensive immunochemotherapy trials. Age >55 years and advanced stage, but not HIV infection, were associated with poor survival. Dose reduction of chemotherapy in young adults in CMR is safe and does not impact outcomes (clinicaltrials gov. Identifier: NCT05049473).

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