NYMC Faculty Publications

Rituximab With Chemotherapy in Children and Adolescents With Central Nervous System and/or Bone Marrow-Positive Burkitt Lymphoma/Leukaemia: A Children's Oncology Group Report

Author Type(s)

Faculty

DOI

10.1111/bjh.13040

Journal Title

British Journal of Haematology

First Page

394

Last Page

401

Document Type

Article

Publication Date

11-1-2014

Department

Medicine

Keywords

Adolescent, Antibodies, Monoclonal, Murine-Derived, Antineoplastic Combined Chemotherapy Protocols, Bone Marrow, Burkitt Lymphoma, Central Nervous System Neoplasms, Child, Consolidation Chemotherapy, Cyclophosphamide, Cytarabine, Disease-Free Survival, Doxorubicin, Drug Administration Schedule, Etoposide, Female, Genes, myc, Humans, Immunotherapy, Infusions, Intravenous, Kaplan-Meier Estimate, Lymphoma, B-Cell, Maintenance Chemotherapy, Male, Methotrexate, Prednisone, Remission Induction, Rituximab, Typhlitis, Vincristine

Disciplines

Medicine and Health Sciences

Abstract

Children and adolescents with Burkitt Lymphoma (BL) and combined central nervous system (CNS) and bone marrow involvement still have a poor prognosis with chemotherapy alone. We therefore investigated in children and adolescents with bone marrow (≥25% blasts) and/or CNS-positive Burkitt lymphoma the chemoimmunotherapy combination of rituximab (375 mg/m(2) ) and the standard chemotherapy arm of our previously reported French-American-British (FAB) Lymphome Malins de Burkitt (LMB) 96 trial. Central pathological and cytogenetic characterization was also performed. There were 40 evaluable patients with Burkitt histology (25 with leukaemia and 15 with CNS disease ± leukaemia). The chemoimmunotherapy regimen was well tolerated. The incidence of grade III/IV mucositis during induction cycles with combined chemotherapy and rituximab was 31% and 26%, respectively. The 3-year event-free survival (EFS)/overall survival (OS) was 90% (95% confidence interval [CI], 76-96%) in the entire cohort and 93% (95% CI, 61-99%) in patients with CNS disease. Based on the results of this trial, an international randomized study of FAB/LMB 96 chemotherapy ± rituximab for high-risk patients is currently under investigation.

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