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. 2014 Apr;165(1):102-11.
doi: 10.1111/bjh.12736. Epub 2014 Jan 15.

Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002

David A Rizzieri  1 , Jeffrey L Johnson, John C Byrd, Gerard Lozanski, Kristie A Blum, Bayard L Powell, Thomas C Shea, Sreenivasa Nattam, Eva Hoke, Bruce D Cheson, Richard A Larson; Alliance for Clinical Trials In Oncology (ACTION)
Affiliations

Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002

David A Rizzieri et al. Br J Haematol. 2014 Apr.

Abstract

To improve long-term outcomes for Burkitt leukaemia/lymphoma (BL) or aggressive lymphomas in adults, we assessed the benefit of adding rituximab and filgrastim support to a dose-dense modified chemotherapy regimen from the Cancer and Leukemia Group B (CALGB) 9251 trial. One hundred and five patients (aged 19-79 years) were enrolled; 27% were >60 years old; 47% had high or high-intermediate risk by International Prognostic Index (IPI) criteria. Common severe toxicities included stomatitis/upper gastrointestinal toxicity (69%), renal insufficiency (10%), neurological events (25%) and pulmonary events (18%). Seven died from treatment-related causes (one central nervous system bleed, four infections, two respiratory failure); five were >60 years old. Results in this adult population are encouraging as complete response (CR) was observed in 83% and 4-year event-free (EFS) and overall survivals (OS) were 74% and 78%, respectively. Results compare favourably to our prior chemotherapy alone study (CALGB 9251) but despite this, high-risk patients still had worse outcomes. In conclusion, short duration, intensive chemo-immunotherapy is feasible and should be considered in adults with BL as it results in high remission rates and durable remissions.

Keywords: Burkitt leukaemia; Burkitt lymphoma; chemo-immunotherapy; rituximab.

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Conflict of interest statement

Conflicts of Interest: The authors report there are no reported conflicts of interest related to this study

Figures

Figure 1
Figure 1. Event-free (A) and overall survival (B) for all patients stratified by IPI criteria in CALGB 10002 and overall survival for all patients stratified by IPI criteria in CALGB 9251 (C)
Though developed for diffuse large B-cell lymphoma, the IPI was found to predict outcomes for our patients with BL as well. The addition of rituximab appears to improve outcomes compared to the prior regimen (CALGB 9251) without. CALGB, Cancer and Leukemia Group B; IPI, International Prognostic Index
Figure 1
Figure 1. Event-free (A) and overall survival (B) for all patients stratified by IPI criteria in CALGB 10002 and overall survival for all patients stratified by IPI criteria in CALGB 9251 (C)
Though developed for diffuse large B-cell lymphoma, the IPI was found to predict outcomes for our patients with BL as well. The addition of rituximab appears to improve outcomes compared to the prior regimen (CALGB 9251) without. CALGB, Cancer and Leukemia Group B; IPI, International Prognostic Index
Figure 1
Figure 1. Event-free (A) and overall survival (B) for all patients stratified by IPI criteria in CALGB 10002 and overall survival for all patients stratified by IPI criteria in CALGB 9251 (C)
Though developed for diffuse large B-cell lymphoma, the IPI was found to predict outcomes for our patients with BL as well. The addition of rituximab appears to improve outcomes compared to the prior regimen (CALGB 9251) without. CALGB, Cancer and Leukemia Group B; IPI, International Prognostic Index
See this image and copyright information in PMC

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