Feasibility of highly intensive chemotherapy for AIDS-related Burkitt lymphoma.

Abstract

e19521 Background: Burkitt lymphoma (BL) progresses very rapidly, but highly intensive chemotherapy (e.g. CODOX-M/IVAC, hyper-CVAD/MA) has been shown to be a promising strategy. In this time, AIDS-related lymphoma is treated with similarly to non-AIDS lymphoma, nevertheless it is not clear whether the highly intensive regimens are feasible and beneficial for AIDS-related Burkitt (AIDS-BL) or not. The purpose of the current study is to compare the toxicity of AIDS-BL to non-AIDS-BL retrospectively. Methods: We collected the data of all patients (pts) with BL between 2004 and 2011 at our institution. Chart review was performed for all identified pts. The effects of treatment and the clinical variables on overall survival (OS) were assessed. Results: We identified 25 Burkitt lymphomas, and a total of 108 cycles of highly intensive chemotherapy were administered. Nine of these 25 were AIDS-BL (median age, 51; range, 36 to 68) and 16 were non-AIDS-BL (median age, 60; range, 27 to 75). As chemotherapeutic regimens, 15 (60%) were treated with CODOX-M/IVAC, 8 (32%) with hyper-CVAD/MA, and 2 (8%) with EPOCH. Of 12 pts (48%) treated with rituximab-contain regimens. Completion rate of planned chemotherapy was 64%. The median follow-up was 34.3 months. Three-year OS was 73.6%. There were no significant differences in OS between chemotherapeutic regimens (p=0.94) and between AIDS-BL and non-AIDS-BL (p=0.39). The overall incidence of grade 3/4 febrile neutropenia was 64.8% (70 of 108 cycles), 60.5% for HIV-infected and 67.7% for HIV-negative case, respectively. Grade 4 thrombocytopenia was frequently observed in AIDS-BL (72.1% vs. 40.0%), and incidence of grade 3/4 anemia was not different (79.1% vs. 70.8%). Conclusions: This study showed that clinical outcomes, including toxicities, of AIDS-BL were similar to non-AIDS-BL when BL treated with highly intensive chemotherapy.