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Dose-intensive chemotherapy including rituximab is highly effective but toxic in human immunodeficiency virus-infected patients with Burkitt lymphoma/leukemia: parallel study of 81 patients

Autores: Xicoy, B.; Ribera, J.M. (Autor de correspondencia); Muller, M.; García, O.; Hoffmann, C.; Oriol, A.; Hentrich, M.; Grande García, Carlos; Wasmuth, J.C.; Esteve, J.; van Lunzen, J.; del Potro, E.; Knechten, H.; Brunet, S.; Mayr, C.; Escoda, L.; Schommers, P.; Alonso, N.; Vall-Llovera, F.; Pérez, M.; Morgades, M.; González, J.; Fernández, A.; Thoden, J.; Gokbuget, N.; Hoelzer, D.; Fatkenheuer, G.; Wyen, C.; PETHEMA Grp; German HIV Lymphoma Cohort
Título de la revista: LEUKEMIA AND LYMPHOMA
ISSN: 1042-8194
Volumen: 55
Número: 10
Páginas: 2341-2348
Fecha de publicación: 2014
Resumen:
The results of intensive immunochemotherapy were analyzed in human immunodeficiency virus (HIV)-related Burkitt lymphoma/leukemia (BLL) in two cohorts (Spain and Germany). Alternating cycles of chemotherapy were administered, with dose reductions for patients over 55 years. Eighty percent of patients achieved remission, 11% died during induction, 9% failed and 7% died in remission. Four-year overall survival (OS) and progression-free survival (PFS) probabilities were 72% (95% confidence interval [CI]: 62-82%) and 71% (95% CI: 61-81%). CD4 T-cell count < 200/mu L and bone marrow involvement were associated with poor OS (hazard ratio [HR] 3.2 [1.2-8.3] and HR 2.7 [1.1-6.6]) and PFS (HR 3.5 [1.3-9.1] and HR 2.4 [1-5.7]), bone marrow involvement with poor disease-free survival (DFS) (HR 14.4 [1.7-119.7] and Eastern Cooperative Oncology Group (ECOG) score > 2 (odds ratio [OR] 11.9 [1.4-99.9]) with induction death. In HIV-related BLL, intensive immunochemotherapy was feasible and effective, but toxic. Prognostic factors were performance status, CD4 T-cell count and bone marrow involvement.
DOI: https://doi.org/10.3109/10428194.2013.878933
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