Short intensive sequential therapy followed by autologous stem cell transplantation in adult Burkitt, Burkitt-like and lymphoblastic lymphoma
The feasibility and efficacy of up-front high-dose sequential chemotherapy followed by autologous stem cell transplantation (ASCT) in previously untreated adults (median age 33 years; range 15-64) with Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL) or lymphoblastic lymphoma (LyLy), both without...
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| Published in: | Leukemia Vol. 19; no. 6; pp. 945 - 952 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Nature Publishing
01-06-2005
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| Abstract | The feasibility and efficacy of up-front high-dose sequential chemotherapy followed by autologous stem cell transplantation (ASCT) in previously untreated adults (median age 33 years; range 15-64) with Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL) or lymphoblastic lymphoma (LyLy), both without central nervous system or extensive bone marrow involvement was investigated in a multicenter phase II study. Treatment consisted of two sequential high-dose chemotherapy induction courses incorporating prednisone, cyclophosphamide, doxorubicin, etoposide and mitoxantrone, without high-dose methotrexate or high-dose cytarabine. Patients with at least PR went on with BEAM and ASCT. Protocol treatment was completed by 23/27 (85%) BL/BLL and 13/15 (87%) LyLy patients. Median treatment duration until BEAM was 70 (range: 50-116) days. No toxic deaths occurred. Response to treatment was complete response (CR) 81% and partial response (PR) 11% for BL/BLL, CR 73% and PR 20% for LyLy. At a median follow-up of 61 months of patients still alive, six BL/BLL and eight LyLy patients have died. The actuarial 5-year overall and event-free survival estimates are 81 and 73% for BL/BLL vs 46 and 40% for LyLy patients. In conclusion, this short up-front high-dose sequential chemotherapy regimen, followed by ASCT is highly effective in adults with BL/BLL with limited bone marrow involvement, but less so in patients with LyLy. |
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| AbstractList | The feasibility and efficacy of up-front high-dose sequential chemotherapy followed by autologous stem cell transplantation (ASCT) in previously untreated adults (median age 33 years; range 15–64) with Burkitt lymphoma (BL), Burkitt-like lymphoma (BLL) or lymphoblastic lymphoma (LyLy), both without central nervous system or extensive bone marrow involvement was investigated in a multicenter phase II study. Treatment consisted of two sequential high-dose chemotherapy induction courses incorporating prednisone, cyclophosphamide, doxorubicin, etoposide and mitoxantrone, without high-dose methotrexate or high-dose cytarabine. Patients with at least PR went on with BEAM and ASCT. Protocol treatment was completed by 23/27 (85%) BL/BLL and 13/15 (87%) LyLy patients. Median treatment duration until BEAM was 70 (range: 50–116) days. No toxic deaths occurred. Response to treatment was complete response (CR) 81% and partial response (PR) 11% for BL/BLL, CR 73% and PR 20% for LyLy. At a median follow-up of 61 months of patients still alive, six BL/BLL and eight LyLy patients have died. The actuarial 5-year overall and event-free survival estimates are 81 and 73% for BL/BLL vs 46 and 40% for LyLy patients. In conclusion, this short up-front high-dose sequential chemotherapy regimen, followed by ASCT is highly effective in adults with BL/BLL with limited bone marrow involvement, but less so in patients with LyLy. |
| Audience | Academic |
| Author | WIJERMANS, P. W KLUIN-NELEMANS, H. C VAN 'T VEER, M. B KRAMER, M. H. H KLUIN, P. M OSSENKOPPELE, G. J VAN MARWIJK KOOY, M SONNEVELD, P RAEMAEKERS, J. M. M VAN IMHOFF, G. W SCHOUTEN, H. C VAN DER HOLT, B MEULENDIJKS, L. A. M. H VAN OERS, M. H. J VERDONCK, L. F MACKENZIE, M. A |
| Author_xml | – sequence: 1 givenname: G. W surname: VAN IMHOFF fullname: VAN IMHOFF, G. W organization: Department of Hematology, University Medical Center Groningen, Groningen, Netherlands – sequence: 2 givenname: B surname: VAN DER HOLT fullname: VAN DER HOLT, B organization: Hovon Data Center, Erasmus MC, Rotterdam, Netherlands – sequence: 3 givenname: J. M. M surname: RAEMAEKERS fullname: RAEMAEKERS, J. M. M organization: Department of Hematology, University Medical Center Nijmegen St Radboud, Nijmegen, Netherlands – sequence: 4 givenname: P surname: SONNEVELD fullname: SONNEVELD, P organization: Department of Hematology, Erasmus MC, Rotterdam, Netherlands – sequence: 5 givenname: L. A. M. H surname: MEULENDIJKS fullname: MEULENDIJKS, L. A. M. H organization: Hovon Data Center, Erasmus MC, Rotterdam, Netherlands – sequence: 6 givenname: P. M surname: KLUIN fullname: KLUIN, P. M organization: Department of Pathology, Groningen University Hospital, Groningen, Netherlands – sequence: 7 givenname: H. C surname: KLUIN-NELEMANS fullname: KLUIN-NELEMANS, H. C organization: Department of Hematology, University Medical Center Groningen, Groningen, Netherlands – sequence: 8 givenname: L. F surname: VERDONCK fullname: VERDONCK, L. F organization: Department of Hematology, University Medical Center Utrecht, Utrecht, Netherlands – sequence: 9 givenname: M. A surname: MACKENZIE fullname: MACKENZIE, M. A organization: Department of Hematology, University Medical Center Nijmegen St Radboud, Nijmegen, Netherlands – sequence: 10 givenname: G. J surname: OSSENKOPPELE fullname: OSSENKOPPELE, G. J organization: Department of Hematology, VU Medical Center, Amsterdam, Netherlands – sequence: 11 givenname: P. W surname: WIJERMANS fullname: WIJERMANS, P. W organization: Department of Internal Medicine, Leyenburg Hospital, The Hague, Netherlands – sequence: 12 givenname: M. H. H surname: KRAMER fullname: KRAMER, M. H. H organization: Department of Internal Medicine, Meander MC, Amersfoort, Netherlands – sequence: 13 givenname: M. B surname: VAN 'T VEER fullname: VAN 'T VEER, M. B organization: Department of Hematology, Erasmus MC, Rotterdam, Netherlands – sequence: 14 givenname: H. C surname: SCHOUTEN fullname: SCHOUTEN, H. C organization: Department of Hematology, Maastricht University Hospital, Maastricht, Netherlands – sequence: 15 givenname: M surname: VAN MARWIJK KOOY fullname: VAN MARWIJK KOOY, M organization: Department of Internal Medicine, Isala Clinics, Zwolle, Netherlands – sequence: 16 givenname: M. H. J surname: VAN OERS fullname: VAN OERS, M. H. J organization: Department of Hematology, Academic Medical Center, Amsterdam, Netherlands |
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| Keywords | Human Hematology Stem cell Burkitt lymphoma Lymphoblastic lymphoma autologous stem cell transplantation Hematopoietic cell Malignant hemopathy Non Hodgkin lymphoma Infection Autograft Treatment Sequential Lymphoproliferative syndrome Viral disease adult Burkitt lymphoma Graft Adult Burkitt-like lymphoma |
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| SubjectTerms | Adolescent Adult Adults Antibiotics, Antineoplastic - administration & dosage Antibiotics, Antineoplastic - adverse effects Antineoplastic Agents, Alkylating - administration & dosage Antineoplastic Agents, Alkylating - adverse effects Antineoplastic Agents, Phytogenic - administration & dosage Antineoplastic Agents, Phytogenic - adverse effects Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Autografts Biological and medical sciences Bone marrow Burkitt Lymphoma - drug therapy Burkitt Lymphoma - mortality Burkitt's lymphoma Central nervous system Chemotherapy Combined Modality Therapy Cyclophosphamide Cyclophosphamide - administration & dosage Cyclophosphamide - adverse effects Cytarabine Doxorubicin Doxorubicin - administration & dosage Doxorubicin - adverse effects Etoposide Etoposide - administration & dosage Etoposide - adverse effects Female Follow-Up Studies Hematologic and hematopoietic diseases Hematopoietic Stem Cell Transplantation Humans Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis Lymphoma Male Medical sciences Methotrexate Middle Aged Mitoxantrone Mitoxantrone - administration & dosage Mitoxantrone - adverse effects Patients Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality Prednisone Prednisone - administration & dosage Prednisone - adverse effects Stem cell transplantation Stem cells Transplantation Transplantation, Autologous |
| Title | Short intensive sequential therapy followed by autologous stem cell transplantation in adult Burkitt, Burkitt-like and lymphoblastic lymphoma |
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