Objective:To characterize modified R-CODOX-M/IVAC-based chemotherapy to lower the severe adverse events in Chinese adult patients with sporadic Burkitt lymphoma.Methods:We enrolled a retrospective cohort including 123...Objective:To characterize modified R-CODOX-M/IVAC-based chemotherapy to lower the severe adverse events in Chinese adult patients with sporadic Burkitt lymphoma.Methods:We enrolled a retrospective cohort including 123 adult patients with untreated sporadic Burkitt lymphoma from August 2008 to September 2019 at Sun Yat-sen University Cancer Center.We studied a dose-modified and long-course R-CODOX-M/IVAC regimen utilizing a low dose of 1.0 g/m2/cycle cyclophosphamide,2 g/m2/cycle methotrexate,4,500 mg/m2/cycle ifosfamide,and 4.0 g/m2/cycle cytarabine.Forty-nine patients with low risk disease underwent 4–6 cycles of dose-modified R-CODOX-M-based chemotherapy.Seventy-four patients with high risk disease underwent 6–8 cycles of dose-modified alternating R-CODOX-M/IVAC regimens.Results:The objective remission was 87.0%.The event-free survival rate and overall survival at 3 years were 81.2%and 92.1%,respectively.Major grade 3–4 adverse events included leukopenia(91.9%),anemia(58.5%),thrombocytopenia(73.2%),and febrile neutropenia(48.8%).A total of 26.0%and 37.4%of patients received red blood cell and platelet transfusions,respectively.We observed 4 cases(3.3%)of septic shock after chemotherapy.Two treatment-related deaths occurred from severe infection.Conclusions:The modified R-CODOX-M/IVAC chemotherapy regimen was effective for sporadic Burkitt lymphoma in the Chinese population,with a lower toxicity than standard regimens.展开更多
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;previo...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.展开更多
基金supported by grants from the Natural Science Foundation of Guangdong Province,China(Grant No.2019A1515010742)。
文摘Objective:To characterize modified R-CODOX-M/IVAC-based chemotherapy to lower the severe adverse events in Chinese adult patients with sporadic Burkitt lymphoma.Methods:We enrolled a retrospective cohort including 123 adult patients with untreated sporadic Burkitt lymphoma from August 2008 to September 2019 at Sun Yat-sen University Cancer Center.We studied a dose-modified and long-course R-CODOX-M/IVAC regimen utilizing a low dose of 1.0 g/m2/cycle cyclophosphamide,2 g/m2/cycle methotrexate,4,500 mg/m2/cycle ifosfamide,and 4.0 g/m2/cycle cytarabine.Forty-nine patients with low risk disease underwent 4–6 cycles of dose-modified R-CODOX-M-based chemotherapy.Seventy-four patients with high risk disease underwent 6–8 cycles of dose-modified alternating R-CODOX-M/IVAC regimens.Results:The objective remission was 87.0%.The event-free survival rate and overall survival at 3 years were 81.2%and 92.1%,respectively.Major grade 3–4 adverse events included leukopenia(91.9%),anemia(58.5%),thrombocytopenia(73.2%),and febrile neutropenia(48.8%).A total of 26.0%and 37.4%of patients received red blood cell and platelet transfusions,respectively.We observed 4 cases(3.3%)of septic shock after chemotherapy.Two treatment-related deaths occurred from severe infection.Conclusions:The modified R-CODOX-M/IVAC chemotherapy regimen was effective for sporadic Burkitt lymphoma in the Chinese population,with a lower toxicity than standard regimens.
文摘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.
