Treatment Outcomes of Rituximab Plus Hyper-CVAD in Korean Patients with Sporadic Burkitt or Burkitt-like Lymphoma: Results of a Multicenter Analysis
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma(BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD)regimen by focusing on tolerability and actual delivered relative dose intensity (RDI). Materials and MethodsPatients 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphomawere treated with at least one cycle of R-hyper-CVAD as the first-line treatment in thisstudy. Eligible patients’ case report forms were requested from their physicians to obtainclinical and laboratory data for this retrospective study. ResultsForty-three patients (median age, 51 years) from 14 medical centers in Korea wereanalyzed, none of which were infected with human immunodeficiency virus. The majority ofpatients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rateswere 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete theR-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin,vincristine, methotrexate, and cytarabine were between 60% and 65%, which means lessthan 25% of patients received greater than 80% of the planned dose of each drug. Poorperformance status was related to the lower RDIs of doxorubicin and methotrexate. ConclusionR-hyper-CVAD showed excellent treatment outcomes in patients who were suitable fordose-intense chemotherapy. However, management of patients who are intolerant to adose-intense regimen remains problematic due to the frequent occurrence of treatmentrelatedcomplications.
Abstract
Purpose This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma(BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD)regimen by focusing on tolerability and actual delivered relative dose intensity (RDI). Materials and MethodsPatients 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphomawere treated with at least one cycle of R-hyper-CVAD as the first-line treatment in thisstudy. Eligible patients’ case report forms were requested from their physicians to obtainclinical and laboratory data for this retrospective study. ResultsForty-three patients (median age, 51 years) from 14 medical centers in Korea wereanalyzed, none of which were infected with human immunodeficiency virus. The majority ofpatients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rateswere 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete theR-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin,vincristine, methotrexate, and cytarabine were between 60% and 65%, which means lessthan 25% of patients received greater than 80% of the planned dose of each drug. Poorperformance status was related to the lower RDIs of doxorubicin and methotrexate. ConclusionR-hyper-CVAD showed excellent treatment outcomes in patients who were suitable fordose-intense chemotherapy. However, management of patients who are intolerant to adose-intense regimen remains problematic due to the frequent occurrence of treatmentrelatedcomplications.
참고문헌 (25)
- Linch DC, "Burkitt lymphoma in adults", Br J Haematol, 156, pp.693~703 (2012)
- 허주령, "Epidemiologic overview of malignant lymphoma", Blood Research, 47(2), pp.92~104 (2012), 대한혈액학회[DOI]
- Magrath I, "The pathogenesis of Burkitt's lymphoma", Adv Cancer Res, 55, pp.133~270 (1990)
- Ostronoff M, "Burkitt's lymphoma in adults : a retrospective study of 46 cases", Nouv Rev Fr Hematol, 34, pp.389~397 (1992)
- Mead GM, "An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma : results of United Kingdom Lymphoma Group LY06study", Ann Oncol, 13, pp.1264~1274 (2002)
- Thomas DA, "Hyper-CVAD program in Burkitt's-type adult acute lymphoblastic leukemia", J Clin Oncol, 17, pp.2461~2470 (1999)
- Costa LJ, "Trends in survival of patients with Burkitt lymphoma", leukemia in the USA : an analysis of 3691 cases, 2013, pp.121, 4861~4866
- Wasterlid T, "Impact of chemotherapy regimen and rituximab in adult Burkitt lymphoma : a retrospective population-based study from the Nordic Lymphoma Group", Ann Oncol, 24, pp.1879~1886 (2013)
- Thomas DA, "Burkitt lymphoma and atypical Burkitt or Burkitt-like lymphoma: should these be treated as different diseases?", Curr Hematol Malig Rep, 6, pp.58~66 (2011)
- Corazzelli G, "RD-CODOX-M", IVAC with rituximab and intrathecal liposomal cytarabine in adult Burkitt lymphoma and 'unclassifiable' highly aggressive B-cell lymphoma, 2012, pp.156, 234~244
- Thomas DA, "Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia", Cancer, 106, pp.1569~1580 (2006)
- 서철원, "Review of the clinical research conducted by the Consortium for Improving Survival of Lymphoma of the Korean Society of Hematology Lymphoma Working Party", Blood Research, 48(3), pp.171~177 (2013), 대한혈액학회
- Cheson BD, "Revised response criteria for malignant lymphoma", J Clin Oncol, 25, pp.579~586 (2007)
- Soussain C, "Small noncleaved cell lymphoma and leukemia in adults. A retrospective study of 65 adults treated with the LMB pediatric protocols", Blood, 85, pp.664~674 (1995)
- Lee EJ, "Brief-duration high-intensity chemotherapy for patients with small noncleaved-cell lymphoma or FAB L3 acute lymphocytic leukemia : results of cancer and leukemia group B study 9251", J Clin Oncol, 19, pp.4014~4022 (2001)
- Mead GM, "A prospective clinicopathologic study of dose-modified CODOX-M", IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria(MRC, Blood, pp.2008, 112[DOI]
- Choi MK, "Treatment outcome of adult patients with Burkitt lymphoma : results using the LMB protocol in Korea", Ann Hematol, 88, pp.1099~1106 (2009)
- Barnes JA, "Evaluation of the addition of rituximab to CODOX-M", IVAC for Burkitt's lymphoma : a retrospective analysis, 2011, pp.22, 1859~1864
- Intermesoli T, "High cure rates in Burkitt lymphoma and leukemia : a Northern Italy Leukemia Group study of the German short intensive rituximab-chemotherapy program", Haematologica, 98, pp.1718~1725 (2013)
- Maruyama D, "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, 2010, pp.92, 732~743
- Freifeld AG, "Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america", Clin Infect Dis, 52, pp.e56~93 (2011)
- Goldman SC, "A randomized comparison between rasburicase and allopurinol in children with lymphoma or leukemia at high risk for tumor lysis", Blood, 97, pp.2998~3003 (2001)
- Alvarnas JC, "Acute lymphoblastic leukemia", J Natl Compr Canc Netw, 10, pp.858~914 (2012)
- Kelly JL, "Outcomes of patients with Burkitt lymphoma older than age 40 treated with intensive chemotherapeutic regimens", Clin Lymphoma Myeloma, 9, pp.307~310 (2009)
- Dunleavy K, "Low-intensity therapy in adults with Burkitt's lymphoma", N Engl J Med, 369, pp.1915~1925 (2013)