Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers

被引：70

作者：

Evens, Andrew M. ^{[1
]}

Danilov, Alexey ^{[2
]}

Jagadeesh, Deepa ^{[3
]}

Sperling, Amy ^{[4
]}

Kim, Seo-Hyun ^{[5
]}

Vaca, Ryan ^{[6
]}

Wei, Catherine ^{[1
]}

Rector, Daniel ^{[7
]}

Sundaram, Suchitra ^{[8
]}

Reddy, Nishitha ^{[9
]}

Lin, Yong ^{[1
]}

Farooq, Umar ^{[10
]}

D'Angelo, Christopher ^{[11
]}

Bond, David A. ^{[12
]}

Berg, Stephanie ^{[13
]}

Churnetski, Michael C. ^{[14
]}

Godara, Amandeep ^{[15
]}

Khan, Nadia ^{[16
]}

Choi, Yun Kyong ^{[17
]}

Yazdy, Maryam ^{[18
]}

Rabinovich, Emma ^{[19
]}

Varma, Gaurav ^{[20
]}

Karmali, Reem ^{[21
]}

Mian, Agrima ^{[3
]}

Savani, Malvi ^{[22
]}

Burkart, Madelyn ^{[21
]}

Martin, Peter ^{[20
]}

Ren, Albert ^{[19
]}

Chauhan, Ayushi ^{[18
]}

Diefenbach, Catherine ^{[17
]}

Straker-Edwards, Allandria ^{[16
]}

Klein, Andreas K. ^{[15
]}

Blum, Kristie A. ^{[14
]}

Boughan, Kirsten Marie ^{[23
]}

Smith, Scott E. ^{[13
]}

Haverkos, Brad M. ^{[24
]}

Orellana-Noia, Victor M. ^{[25
]}

Kenkre, Vaishalee P. ^{[11
]}

Zayac, Adam ^{[26
]}

Ramdial, Jeremy ^{[27
]}

Maliske, Seth M. ^{[10
]}

Epperla, Narendranath ^{[12
]}

Venugopal, Parameswaran ^{[5
]}

Feldman, Tatyana A. ^{[7
]}

Smith, Stephen D. ^{[4
]}

Stadnik, Andrzej ^{[2
]}

David, Kevin A. ^{[1
]}

Naik, Seema ^{[6
]}

Lossos, Izidore S. ^{[27
]}

Lunning, Matthew A. ^{[28
]}

机构：

[1] Rutgers Robert Wood Johnson Med Sch, Rutgers Canc Inst New Jersey, New Brunswick, NJ USA

[2] Oregon Hlth & Sci Univ, Knight Canc Inst, Div Hematol & Med Oncol, Portland, OR 97201 USA

[3] Cleveland Clin, Taussig Canc Inst, Dept Hematol & Med Oncol, Cleveland, OH 44106 USA

[4] Univ Washington, Fred Hutchinson Canc Res Ctr, Div Med Oncol, Seattle, WA 98195 USA

[5] Rush Univ, Med Ctr, Div Hematol Oncol, Chicago, IL 60612 USA

[6] Penn State Univ, Coll Med, Penn State Canc Inst, Div Hematol Oncol, Hershey, PA USA

[7] Hackensack Univ Med Ctr, John Theurer Canc Ctr, Div Hematol Oncol, Hackensack, NJ USA

[8] Roswell Pk Comprehens Canc Ctr, Div Hematol Oncol, Buffalo, NY USA

[9] Vanderbilt Univ, Med Ctr, Div Hematol Oncol, Nashville, TN USA

[10] Univ Iowa, Div Hematol Oncol & Blood & Marrow Transplant, Iowa City, IA USA

[11] Univ Wisconsin, Carbone Canc Ctr, Div Hematol Oncol, Madison, WI USA

[12] Ohio State Univ Hosp, James Canc Ctr, Div Hematol, Columbus, OH 43210 USA

[13] Loyola Univ Med Ctr, Div Hematol Oncol, Maywood, IL 60153 USA

[14] Emory Univ, Med Ctr, Winship Canc Inst, Div Hematol Oncol, Atlanta, GA 30322 USA

[15] Tufts Med Ctr, Div Hematol Oncol, Boston, MA 02111 USA

[16] Fox Chase Canc Ctr, Div Hematol Oncol, 7701 Burholme Ave, Philadelphia, PA 19111 USA

[17] NYU, Sch Med, NYU Canc Inst, Div Hematol Oncol, New York, NY USA

[18] Georgetown Univ Hosp, Lombardi Comprehens Canc Ctr, Div Hematol Oncol, Washington, DC 20007 USA

[19] Univ Illinois, Div Hematol Oncol, Chicago, IL USA

[20] New York Presbyterian Hosp, Weill Cornell Med, Div Hematol Oncol, New York, NY USA

[21] Northwestern Univ, Feinberg Sch Med, Robert H Lurie Comprehens Canc Ctr, Div Hematol Oncol, Chicago, IL 60611 USA

[22] Univ Minnesota, Div Hematol Oncol, Minneapolis, MN USA

[23] Univ Hosp Seidman Canc Ctr, Div Hematol Oncol, Cleveland, OH USA

[24] Univ Colorado, Div Hematol, Denver, CO 80202 USA

[25] Univ Virginia, Div Hematol Oncol, Charlottesville, VA USA

[26] Brown Univ, Div Hematol Oncol, Providence, RI 02912 USA

[27] Univ Miami, Sch Med, Sylvester Comprehens Canc Ctr, Div Hematol, Miami, FL USA

[28] Univ Nebraska, Div Hematol Oncol, Omaha, NE 68182 USA

[29] Thomas Jefferson Univ Hosp, Div Hematol Oncol, Philadelphia, PA 19107 USA

[30] Univ Michigan, Div Hematol Oncol, Ann Arbor, MI 48109 USA

来源：

BLOOD | 2021年 / 137卷 / 03期

关键词：

MODIFIED CODOX-M/IVAC; B-CELL; ADULT BURKITT; RITUXIMAB; CHEMOTHERAPY; LYMPHOMA/LEUKEMIA; CLASSIFICATION; CHILDREN; SURVIVAL; EFFICACY;

D O I：

10.1182/blood.2020006926

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We examined adults with untreated Burkitt lymphoma (BL) from 2009 to 2018 across 30 US cancer centers. Factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Among 641 BL patients, baseline features induded the following: median age, 47 years; HIV+, 22%; Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 to 4, 23%; >1 extranodal site, 43%; advanced stage, 78%; and central nervous system (CNS) involvement, 19%. Treatment-related mortality was 10%, with most common causes being sepsis, gastrointestinal bleed/perforation, and respiratory failure. With 45-month median follow-up, 3-year PFS and OS rates were 64% and 70%, respectively, without differences by HIV status. Survival was better for patients who received rituximab vs not (3-year PFS, 67% vs 38%; OS, 72% vs 44%; P < .001) and without difference based on setting of administration (ie, inpatient vs outpatient). Outcomes were also improved at an academic vs community cancer center (3-year PFS, 67% vs 46%, P = .006; OS, 72% vs 53%, P = .01). In multivariate models, age >= 40 years (PFS, hazard ratio [HR] = 1.70, P = .001; OS, HR = 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR = 1.60, P < .001; OS, HR = 1.74, P = .003), lactate dehydrogenase > 3x normal (PFS, HR = 1.83, P < .001; OS, HR = 1.63, P = .009), and CNS involvement (PFS, HR = 1.52, P = .017; OS, HR = 1.67, P = .014) predicted inferior survival. Furthermore, survival varied based on number of factors present (0, 1, 2 to 4 factors) yielding 3-year PFS rates of 91%, 73%, and 50%, respectively; and 3-year OS rates of 95%, 77%, and 56%, respectively. Collectively, outcomes for adult BL in this real-world analysis appeared more modest compared with results of clinical trials and smaller series. In addition, clinical prognostic factors at diagnosis identified patients with divergent survival rates.

引用

页码：374 / 386

页数：13

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