Research ArticleOpen AccessGoogle Scholar indexed

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

¹ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
² Feinberg School of Medicine, Northwestern University, Chicago, USA
³ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
⁴ Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
⁵ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
⁶ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
⁷ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
⁸ Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada
⁹ Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada
¹⁰ Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada
¹¹ Department of Pharmacy, Sunnybrook Health Sciences Centre, Toronto, Canada
¹² Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
¹³ Hematology/Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada

Journal of Cancer Therapy·Volume 06 (2014)·Pages 1–11·Published 26 December 2014·DOI10.4236/jct.2015.61001

Abstract

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.

KeywordsBurkitt LymphomaBurkitt-Like LymphomaCODOX-M/IVACMYCRituximab

Swerdlo, S., Campo, E., Harris, N., et al. (2008) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press, Lyon.
Haralambieva, E., Boerma, E.J., Van Imhoff, G.W., et al. (2005) Clinical, Immunophenotypic, and Genetic Analysis of Adult Lymphomas with Morphologic Features of Burkitt Lymphoma. The American Journal of Surgical Pathology, 29, 1086-1094.
Magrath, I., Adde, M., Shad, A., et al. (1996) Adults and Children with Small Non-Cleaved-Cell Lymphoma Have a Similar Excellent Outcome When Treated with the Same Chemotherapy Regimen. Journal of Clinical Oncology, 14, 925-934.
Magrath, I.T., Janus, C. and Sariban, E. (1984) Therapy of Localized Non-Hodgkin’s Lymphoma in Children. Journal of Clinical Oncology, 2, 140-141.
Mead, G.M., Barrans, S.L., Qian, W., et al. (2008) A Prospective Clinicopathologic Study of Dose-Modified CODOX-M/IVAC in Patients with Sporadic Burkitt Lymphoma Defined Using Cytogenetic and Immunophenotypic Criteria (MRC/NCRI LY10 Trial). Blood, 112, 2248-2260. http://dx.doi.org/10.1182/blood-2008-03-145128
Lacasce, A., Howard, O., Lib, S., et al. (2004) Modified Magrath Regimens for Adults with Burkitt and Burkitt-Like Lymphomas: Preserved Efficacy with Decreased Toxicity. Leukemia & Lymphoma, 45, 761-767. http://dx.doi.org/10.1080/1042819031000141301
Mead, G.M., Sydes, M.R., Walewski, J., et al. (2002) An International Evaluation of CODOX-M and CODOX-M Alternating with IVAC in Adult Burkitt’s Lymphoma: Results of United Kingdom Lymphoma Group LY06 study. Annals of Oncology, 13, 1264-1274. http://dx.doi.org/10.1093/annonc/mdf253
Barnes, J.A., Lacasce, A.S., Feng, Y., et al. (2011) Evaluation of the Addition of Rituximab to CODOX-M/IVAC for Burkitt’s Lymphoma: A Retrospective Analysis. Annals of Oncology, 22, 1859-1864. http://dx.doi.org/10.1093/annonc/mdq677
Maruyama, D., Watanabe, T., Maeshima, A.M., et al. (2010) Modified Cyclophosphamide, Vincristine, Doxorubicin, and Methotrexate (CODOX-M)/Ifosfamide, Etoposide, and Cytarabine (IVAC) Therapy with or without Rituximab in Japanese Adult Patients with Burkitt Lymphoma (BL) and B Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B Cell Lymphoma and BL. International Journal of Hematology, 92, 732-743. http://dx.doi.org/10.1007/s12185-010-0728-0
Mohamedbhai, S.G., Sibson, K., Marafioti, T., et al. (2011) Rituximab in Combination with CODOX-M/IVAC: A Retrospective Analysis of 23 Cases of Non-HIV Related B-Cell Non-Hodgkin Lymphoma with Proliferation Index >95%. British Journal of Haematology, 152, 175-181. http://dx.doi.org/10.1111/j.1365-2141.2010.08447.x

Menu

Menu

Menu

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

Abstract

References (24)