Chemotherapy Treatments for Burkitt Lymphoma: Systematic Review of Interventional Studies.

Autor: Della Rocca AM; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, PR, Brazil., Leonart LP; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, PR, Brazil., Ferreira VL; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, PR, Brazil., Tonin FS; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, PR, Brazil., Steffenello-Durigon G; Hematology Service, University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, SC, Brazil., Del Moral JAG; Hematology Service, University Hospital Professor Polydoro Ernani de São Thiago, Federal University of Santa Catarina, Florianópolis, SC, Brazil., Fernandez-Llimos F; Center for Health Technology and Services Research (CINTESIS), Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal. Electronic address: fllimos@ff.up.pt., Pontarolo R; Pharmaceutical Sciences Postgraduate Program, Federal University of Paraná, Curitiba, PR, Brazil; Department of Pharmacy, Federal University of Paraná, Curitiba, PR, Brazil. Electronic address: pontarolo@ufpr.br.
Jazyk: angličtina
Zdroj: Clinical lymphoma, myeloma & leukemia [Clin Lymphoma Myeloma Leuk] 2021 Aug; Vol. 21 (8), pp. 514-525. Date of Electronic Publication: 2021 Apr 03.
DOI: 10.1016/j.clml.2021.03.012
Abstrakt: Background: Burkitt lymphoma (BL) is an aggressive hematologic cancer. This study synthetized the evidence about the efficacy and safety of chemotherapy treatments used in patients with BL using the World Health Organization classification.
Materials and Methods: A systematic review of interventional studies was performed. A search was carried out in PubMed, Scopus, and Web of Science, with additional manual and gray literature searches. The methodological quality of articles was assessed with the Newcastle-Ottawa scale.
Results: We identified 1358 studies; 9 nonrandomized studies satisfied the eligibility criteria (n = 544 patients). The BL epidemiologic variants were sporadic BL (44.5%), endemic BL (47.2%), and immunodeficiency-associated BL (8.3%). Regarding chemotherapy protocols, 4 groups were identified: based on CODOX-M/IVAC (n = 4), EPOCH (n = 1), BFM (n = 1), and simplified treatment schemes used in African countries (n = 3). Most studies had moderate quality. Empirically and qualitatively, the best options for adults with sporadic BL were 'DA-EPOCH-R' (7-year overall survival [OS], 100%; 95% confidence interval [CI], 82-100), 'HDR + LD into CODOX-M/IVAC' (2-year OS, 84%), and 'RD-CODOX-M/IVAC' (4-year progression-free survival, 92%; 95% CI, 77-100); in pediatric patients, the 'BFM-NHL-90-like' showed promising results (3-year OS, 90%). For immunodeficiency-associated BL, the 'SC-EPOCH-RR' demonstrated a good therapeutic profile (6-year OS, 90%; 95% CI, 60-98). The 'Malawi 2012-2014' (1-year OS, 73%; 95% CI, 61-85) could be the treatment choice in endemic BL (African countries). The main adverse events were hematologic.
Conclusion: Selecting chemotherapy protocols for BL should be grounded in its epidemiologic variants. Further studies with greater methodological quality are needed to strengthen the evidence.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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