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.
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/μL 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.
['Xicoy|Blanca|B|', 'Ribera|Josep-Maria|JM|', 'Müller|Markus|M|', 'García|Olga|O|', 'Hoffmann|Christian|C|', 'Oriol|Albert|A|', 'Hentrich|Marcus|M|', 'Grande|Carlos|C|', 'Wasmuth|Jan-Christian|JC|', 'Esteve|Jordi|J|', 'van Lunzen|Jan|J|', 'Del Potro|Eloy|E|', 'Knechten|Heribert|H|', 'Brunet|Salut|S|', 'Mayr|Christoph|C|', 'Escoda|Lourdes|L|', 'Schommers|Philipp|P|', 'Alonso|Natalia|N|', 'Vall-Llovera|Ferran|F|', 'Pérez|Montserrat|M|', 'Morgades|Mireia|M|', 'González|José|J|', 'Fernández|Angeles|A|', 'Thoden|Jan|J|', 'Gökbuget|Nicola|N|', 'Hoelzer|Dieter|D|', 'Fätkenheuer|Gerd|G|', 'Wyen|Christoph|C|', '|||']
D000328:Adult D000368:Aged D058846:Antibodies, Monoclonal, Murine-Derived D000971:Antineoplastic Combined Chemotherapy Protocols D002051:Burkitt Lymphoma D015331:Cohort Studies D005260:Female D005858:Germany D015658:HIV Infections D006801:Humans D008297:Male D008875:Middle Aged D009362:Neoplasm Metastasis D009367:Neoplasm Staging D011379:Prognosis D000069283:Rituximab D013030:Spain D016896:Treatment Outcome D055815:Young Adult
prognostic factors Burkitt lymphoma or leukemia HIV infection Specific chemotherapy