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

Autor: Josep-Maria Ribera, Mireia Morgades, Olga Garcia-Calduch, Maialen Sirvent, Buenaventura Buendia, Marta Cervera, Hugo Luzardo, Jesus-Maria Hernandez-Rivas, Marta Sitges, Irene Garcia-Cadenas, Pau Abrisqueta, Pau Montesinos, Mariana Bastos-Oreiro, Maria-Paz Queipo de Llano, Pilar Bravo, Anna Torrent, Pilar Herrera, Antoni Garcia-Guinon, Ferran Vall-llovera, Josefina Serrano, Maria-Jose Terol, Juan-Miguel Bergua, Ana Garcia-Noblejas, Cristina Barrenetxea, Laura Llorente, Daniel Garcia-Belmonte, Eva Gimeno, Antonia Cladera, Santiago Mercadal, Juan-Manuel Sancho
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Haematologica, Vol 109, Iss 2 (2023)
Druh dokumentu: article
ISSN: 0390-6078
1592-8721
DOI: 10.3324/haematol.2023.283342
Popis: 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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