Feasibility and outcomes after dose reduction of immunochemotherapy in young adults with Burkitt lymphoma and leukemia: results of the BURKIMAB14 trial

High dose-intensive or infusional intermediate-dose immunochemotherapy is highly effective treatment for Burkitt lymphoma irrespective of human immunodeficiency virus (HIV) infection. However, toxicities of these regimens are relevant, especially in older adults and elderly patients. The prospective...

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Detalles Bibliográficos
Autores: Ribera, Josep-Maria, Morgades, Mireia, Garcia-Calduch, Olga, Sirvent, Maialen, Buendia, Buenaventura, Cervera, Marta, Luzardo, Hugo, Hernandez-Rivas, Jesus-Maria, Sitges, Marta, Garcia-Cadenas, Irene, Abrisqueta, Pau, Montesinos, Pau, Bastos-Oreiro, Mariana, Queipo De Llano, Maria-Paz, Bravo, Pilar, Torrent-Colomer, Anna, Herrera, Pilar, Garcia-Guinon, Antoni, Vall-Llovera, Ferran, Serrano, Josefina, Terol, María José, Bergua, Juan-Miguel, Garcia-Noblejas, Ana, Barrenetxea, Cristina, Llorente, Laura, Garcia-Belmonte, Daniel, Gimeno, Eva, Cladera-Serra, Antonia, Mercadal, Santiago, Sancho, Juan-Manuel
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/20318
Acceso en línea:https://hdl.handle.net/20.500.13003/20318
Access Level:acceso abierto
Palabra clave:Aged
Young Adult
Drug Tapering
Doxorubicin
Leukemia
Cyclophosphamide
Humans
Antineoplastic Combined Chemotherapy Protocols
Middle Aged
Feasibility Studies
Rituximab
Burkitt Lymphoma
HIV Infections
Prospective Studies
Infecciones por VIH
Reducción Gradual de Medicamentos
Linfoma de Burkitt
Estudios de Factibilidad
Ciclofosfamida
Humanos
Persona de Mediana Edad
Adulto Joven
Estudios Prospectivos
Protocolos de Quimioterapia Combinada Antineoplásica
Anciano
Doxorrubicina
Leucemia
Descripción
Sumario:High dose-intensive or infusional intermediate-dose immunochemotherapy is highly effective treatment for Burkitt lymphoma irrespective of human immunodeficiency virus (HIV) infection. However, toxicities of these regimens are relevant, especially in older adults and elderly patients. The prospective multicenter BURKIMAB14 trial included four to six blocks of immunochemotherapy according to stage (localized: 1 and 2 non-bulky; advanced: 2 bulky, 3, 4) and age, with dose reduction in patients >55 years old. Dose-intensity of chemotherapy was reduced in patients ≤55 years old after achieving complete metabolic response (CMR). Their outcomes were compared with those of similar patients included in the former BURKIMAB08 trial, in which there was no dose reduction. CMR was attained in 86 of 107 (80%) patients (17/19 in localized stages and 69/88 in advanced stages). Patients from the BURKIMAB14 trial ≤55 years old showed similar overall survival (OS), fewer infections and cytopenias than patients from the BURKIMAB08 trial. Patients >55 years old had a significantly higher treatment- related mortality despite dose reduction of chemotherapy. With a median follow-up of 3.61 years the 4-year OS probability was 73% (range, 63-81%). Age (≤55 vs. >55 years) and stage (localized vs. advanced) had prognostic significance. No significant differences in OS were observed in HIV-positive versus HIV-negative patients. The results of BURKIMAB14 are similar to those of other dose-intensive immunochemotherapy trials. Age >55 years and advanced stage, but not HIV infection, were associated with poor survival. Dose reduction of chemotherapy in young adults in CMR is safe and does not impact outcomes (clinicaltrials gov. Identifier: NCT05049473).

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