Rituximab Improves Overall Survival in Patients Treated with CODOX-M/IVAC for Burkitt Lymphoma (BL) and B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and BL (BCL-U): A Single Center Experience and Review of the Literature
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Author(s)
A. Prica1, A. Pratzer2, M. Cheung1, K. Thompson3, E. Piliotis1, N. L. Berinstein1, K. Imrie1, R. Pradhan4, A. Vyas4, Z. Ghorab4, D. Good4, L. Zhang1, R. Buckstein1*
1Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
2Feinberg School of Medicine, Northwestern University, Chicago, USA.
3Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
4Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada.
2Feinberg School of Medicine, Northwestern University, Chicago, USA.
3Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.
4Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada.
Background: Dose-modified (dm)
CODOX-M/IVAC is commonly used for Burkitt lymphoma (BL) and B-cell lymphoma,
unclassifiable, with features intermediate between diffuse large B-cell lymphoma
(DLBCL) and BL (BCL-U; previously Burkitt-like lymphoma-BLL). Methods: We
evaluated the clinical characteristics, outcomes and prognostic markers in
patients treated with dmCODOX-M/IVAC+/- rituximab (R) at a single academic
center. Results: 31 patients with BL (n =
21) or BCL-U (n = 10) were included.
The median age was 45, and 90% were high risk. The 2-year overall survival (OS)
and progression-free survival (PFS) were 69% and 62%, respectively, with no differences
between BL and BCL-U. By multivariable analysis, rituximab use was
significantly associated with improved OS (Hazard Ratio 0.15; 95% CI 0.04 - 0.56)
while elevated LDH (Hazard Ratio 2.84, 95% CI 1.52 - 5.29) and rituximab use
(Hazard Ratio 0.054, 95% CI 0.01 - 0.32) predicted PFS. Conclusion:
DmCODOX-M/IVAC+/- R chemotherapy provides equivalent survival for both BL and
BCL-U patients. The addition of rituximab improves overall and progression free
survival and is recommended.
KEYWORDS
Cite this paper
Prica, A. , Pratzer, A. , Cheung, M. , Thompson, K. ,
Piliotis, E. , Berinstein, N. , Imrie, K. , Pradhan, R. , Vyas, A. ,
Ghorab, Z. , Good, D. , Zhang, L. and Buckstein, R. (2015) Rituximab
Improves Overall Survival in Patients Treated with CODOX-M/IVAC for
Burkitt Lymphoma (BL) and B-Cell Lymphoma, Unclassifiable, with Features
Intermediate between Diffuse Large B-Cell Lymphoma and BL (BCL-U): A
Single Center Experience and Review of the Literature. Journal of Cancer Therapy, 6, 1-11. doi: 10.4236/jct.2015.61001.
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