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Observational Study
. 2018 Feb;97(2):255-266.
doi: 10.1007/s00277-017-3167-7. Epub 2017 Dec 6.

Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens

L E M Oosten  1   2 , M E D Chamuleau  3 , F W Thielen  4 , L C de Wreede  5 , C Siemes  6   7 , J K Doorduijn  6 , O S Smeekes  8 , M J Kersten  8 , L Hardi  3   9 , J W Baars  10 , A M P Demandt  11 , W B C Stevens  12 , M Nijland  13 , G W van Imhoff  13 , R Brouwer  14 , C A Uyl-de Groot  4 , P M Kluin  15 , D de Jong  16 , H Veelken  17
Affiliations
Observational Study

Treatment of sporadic Burkitt lymphoma in adults, a retrospective comparison of four treatment regimens

L E M Oosten et al. Ann Hematol. 2018 Feb.

Abstract

Burkitt lymphoma is an aggressive B cell malignancy accounting for 1-2% of all adult lymphomas. Treatment with dose-intensive, multi-agent chemotherapy is effective but associated with considerable toxicity. In this observational study, we compared real-world efficacy, toxicity, and costs of four frequently employed treatment strategies for Burkitt lymphoma: the Lymphome Malins B (LMB), the Berlin-Frankfurt-Münster (BFM), the HOVON, and the CODOX-M/IVAC regimens. We collected data from 147 adult patients treated in eight referral centers. Following central pathology assessment, 105 of these cases were accepted as Burkitt lymphoma, resulting in the following treatment groups: LMB 36 patients, BFM 19 patients, HOVON 29 patients, and CODOX-M/IVAC 21 patients (median age 39 years, range 14-74; mean duration of follow-up 47 months). There was no significant difference between age, sex ratio, disease stage, or percentage HIV-positive patients between the treatment groups. Five-year progression-free survival (69%, p = 0.966) and 5-year overall survival (69%, p = 0.981) were comparable for all treatment groups. Treatment-related toxicity was also comparable with only hepatotoxicity seen more frequently in the CODOX/M-IVAC group (p = 0.004). Costs were determined by the number of rituximab gifts and the number of inpatients days. Overall, CODOX-M/IVAC had the most beneficial profile with regards to costs, treatment duration, and percentage of patients completing planned treatment. We conclude that the four treatment protocols for Burkitt lymphoma yield nearly identical results with regards to efficacy and safety but differ in treatment duration and costs. These differences may help guide future choice of treatment.

Keywords: Burkitt lymphoma; Cost analysis; Drug therapy; Survival.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Central pathology assessment flow chart
Fig. 2
Fig. 2
a Progression-free survival of BL patients treated with the LMB, BFM, HOVON, or CODOX-M/IVAC regimens. b Overall survival of BL patients treated with the LMB, BFM, HOVON, or CODOX-M/IVAC regimens. LMB, black line; BFM, red line; HOVON, green line; and CODOX-M/IVAC, blue line
See this image and copyright information in PMC

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