Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2014 Sep;15(9):1117-9.
doi: 10.4161/cbt.29504. Epub 2014 Jun 11.

Prolonged low intensity EPOCH-rituximab has improved toxicity in Burkitt lymphoma compared with standard short, high intensity therapy

Shandiz Shahbazi  1 , Cody J Peer  1 , William D Figg  1
Affiliations
Comment

Prolonged low intensity EPOCH-rituximab has improved toxicity in Burkitt lymphoma compared with standard short, high intensity therapy

Shandiz Shahbazi et al. Cancer Biol Ther. 2014 Sep.

Abstract

Burkitt lymphoma is an aggressive form of non-Hodgkin lymphoma that has a short doubling time, thus intense short-cycle chemotherapy has been thought to be essential. A recent NCI-sponsored clinical trial investigated DA-EPOCH-R given to 19 HIV-negative patients and a short course regimen (SC-EPOCH-RR) given to 11 HIV-positive patients in hopes of maintaining the efficacy of the regimen while decreasing the typical side effects from the intensive short-cycle chemotherapy. Low intensity EPOCH-R based therapy achieved excellent rates of efficacy despite a significant difference in the median cumulative dose between the DA-EPOCH-R and SC-EPOCH-RR cohorts. Furthermore, both cohorts experienced mainly grade 1 and grade 2 toxicities, with SC-EPOCH-RR cohort patients experiencing less adverse events than DA-EPOCH-R cohort patients. This recent clinical investigation suggests the most important therapeutic principle is not the intensity but rather the length of exposure time above an effective threshold concentration. Since short, intense bolus doses are the standard therapy for Burkitt lymphoma, these findings are clinically relevant and significant.

Keywords: Burkitt lymphoma; EPOCH regimen; low-intensity therapy.

PubMed Disclaimer

Comment on

  • Low-intensity therapy in adults with Burkitt's lymphoma.
    Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES, Little RF, Wilson WH. Dunleavy K, et al. N Engl J Med. 2013 Nov 14;369(20):1915-25. doi: 10.1056/NEJMoa1308392. N Engl J Med. 2013. PMID: 24224624 Free PMC article. Clinical Trial.

References

    1. Burkitt’s Lymphoma Fact Sheet [pamphlet]. Australia: Leukemia Foundation; 2012. Available from: http://www.leukaemia.com/web/aboutdiseases/docs/Factsheet-Lymphoma-Burki...
    1. Ribera JM, García O, Grande C, Esteve J, Oriol A, Bergua J, González-Campos J, Vall-Llovera F, Tormo M, Hernández-Rivas JM, et al. Dose-intensive chemotherapy including rituximab in Burkitt’s leukemia or lymphoma regardless of human immunodeficiency virus infection status: final results of a phase 2 study (Burkimab) Cancer. 2013;119:1660–8. doi: 10.1002/cncr.27918. - DOI - PubMed
    1. Ferry JA. Burkitt’s lymphoma: clinicopathologic features and differential diagnosis. Oncologist. 2006;11:375–83. doi: 10.1634/theoncologist.11-4-375. - DOI - PubMed
    1. Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES, Little RF, et al. Low-intensity therapy in adults with Burkitt’s lymphoma. N Engl J Med. 2013;369:1915–25. doi: 10.1056/NEJMoa1308392. - DOI - PMC - PubMed
    1. Burkitt Lymphoma [Internet]. Cancer Health Center. Available from: http://www.webmd.com/cancer/burkitt-lymphoma-prognosis-diagnosis-treatments