Treatment of Burkitt lymphoma: A single institution’s experience

Abstract

6742 Background: Burkitt lymphoma (BL) is one of the clinically aggressive NHLs. McMaster et al. (JCO 9:941–6, 1991) presented an 8-week, 7-drug regimen for aggressive lymphomas, with a CR of 81% for BL. Cabanillas et al (PASCO 2003, abs# 2309, 2003) treated BL with hyper-CVAD plus rituximab, delivered over 32 weeks, with a CR rate of 89%. One year survival, however, is only approximately 60% by these or other regimens. Our medical center serves a largely indigent urban population; we report here a retrospective study of our experience with these two regimens. Methods: Over the past 7 years, 9 cases were identified: median age 42 years (range 26–55); male: female ratio 8:1; HIV infection 6 pts; stage I-II (2 pts); III-IV (7 pts); and ECOG 0–1 (8 pts) and 2 (1 pt). Patients were treated by McMaster regimen (McM), hyper-CVAD, CHOP or EPOC regimens with rituximab at the discretion of the treating physician. Results: Two pts. treated with CHOP achieved a PR; one was unsuccessfully salvaged with EPOCH (died at 3 mos.), and one was successfully salvaged with McM with rituximab (McM+R) (NED at 51 months). One pt. treated with EPOCH+R achieved a PR and failed salvage with McM+R. One pt. treated with hyper-CVAD+R achieved a CR. Four pts. were treated by McM, 1 with and 3 without rituximab, with 3 of 4 achieving a durable. All received CNS prophylaxis. Pt.#5 presented with CNS disease. Pt. #2 suffered a CNS relapse at 17 mos. and was salvaged with high dose MTX. One patient refused therapy. Primary prophylaxis with G-CSF was done throughout. Grade 4 hematological toxicities occurred in all patients; septic deaths occurred only in PR/NR pts. Conclusions: At our institution, 4 of the 6 patients treated with McM regimen had a durable CR. This regimen remains an attractive option for the treatment of BL. No significant financial relationships to disclose.