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. 2024 Jun 3;29(6):e789-e795.
doi: 10.1093/oncolo/oyae017.

The Treatment of Burkitt Lymphoma With the Berlin-Frankfurt-Münster Protocol With Rituximab and Consolidative Autologous Transplantation

Alessandro Broccoli  1   2 , Lisa Argnani  2 , Gabriele Gugliotta  1 , Cinzia Pellegrini  1 , Beatrice Casadei  1 , Gianmarco Bagnato  1   2 , Marianna Gentilini  1   2 , Vittorio Stefoni  1   2 , Pier Luigi Zinzani  1   2
Affiliations

The Treatment of Burkitt Lymphoma With the Berlin-Frankfurt-Münster Protocol With Rituximab and Consolidative Autologous Transplantation

Alessandro Broccoli et al. Oncologist. .

Abstract

Introduction: Intensive treatment approaches are required for adult patients with Burkitt lymphoma (BL), although an univocal standard of care still does not exist. The use of frontline autologous stem cells transplantation (ASCT) is debated.

Patients and methods: Between 2004 and 2020, 50 patients with BL were treated with the Berlin-Frankfurt-Münster (BFM). Treatment plan consisted of 3 blocks, A (ifosfamide, vincristine, methotrexate, etoposide, and cytarabine), B (vincristine, cyclophosphamide, methotrexate, and doxorubicin), and C (vindesine, methotrexate, etoposide, and cytarabine), each repeated twice, every 28 days. Rituximab was given at day 1 each block. Intrathecal prophylaxis was given once per each block. ASCT was scheduled at the end of the 6 blocks after conditioning.

Results: Median age at onset was 38 years (range 16-72); stages III-IV disease was observed in 82% of cases; bulky disease occurred in 44% of the patients, with B-symptoms in 38%. Stem cell harvest was performed in 72% of patients, who all received a subsequent ASCT. The full 6 blocks treatment was completed in 70% of the patients. The overall response rate was 74%, with a complete response rate of 60%. Ten-year overall survival and progression-free survival were 83.7% and 76.0%, respectively, without reaching the median. Ten-year disease-free survival was 80.3%. Grades 3-4 neutropenia, thrombocytopenia, anemia, and mucositis were seen in 96%, 60%, 32%, and 24% of patients. Infections occurred in 60% of patients.

Conclusion: Intensive treatment according to BFM protocol, with rituximab and ASCT, appears feasible, safe, and highly effective in adult patients with BL, as confirmed by long-term survival rates reflecting response maintenance.

Keywords: BFM regimen; Burkitt lymphoma; autologous transplantation; methotrexate; rituximab.

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Conflict of interest statement

Alessandro Broccoli reported advisory board member for Sandoz, Takeda, and Kyowa Kirin; research funding from Sandoz and Janssen; honoraria from Merck, Janssen, Takeda, and AstraZeneca. The other authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
Disease-free survival, progression-free survival, and overall survival curves plotted for the entire population.
Figure 2.
Figure 2.
Progression-free and overall survival curves according to age.
Figure 3.
Figure 3.
Progression-free and overall survival curves according to transplant status.
Figure 4.
Figure 4.
Progression-free (A-C) and overall survival (B-D) curves according to disease stage at presentation.
See this image and copyright information in PMC

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