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Annals of Oncology Advance Access originally published online on November 10, 2005
Annals of Oncology 2005 16(12):1928-1935; doi:10.1093/annonc/mdi403
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© 2005 European Society for Medical Oncology

Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol

M. Diviné1, P. Casassus2, S. Koscielny3, J. Bosq3, C. Sebban4, C. Le Maignan5, A. Stamattoulas6, B. Dupriez7, M. Raphaël8, J.-L. Pico3, V. Ribrag3 On behalf of GELA and GOELAMS

1 Hôpital Henri Mondor, Créteil; 2 Hôpital Avicenne, Bobigny; 3 Institut Gustave Roussy, Villejuif; 4 Centre Léon Bérard, Lyon; 5 Hôpital Européen Georges Pompidou, Paris; 6 Centre Henri Becquerel, Rouen; 7 Hôpital du Docteur Schaffner, Lens; 8 Hôpital Bicêtre, Kremlin Bicêtre, France

*Correspondence to: Dr V. Ribrag, Département de Médecine, Institut Gustave-Roussy, 39 Rue C Desmoulins, 94805 Villejuif, France. Tel: +33-1-42-11-4507; Fax: +33-1-42-11-5272; E-mail: ribrag{at}ig.fr

Background: We conducted a phase II study to evaluate in 72 adult patients the efficacy of the intensive LMB chemotherapy regimen, previously reported by the Société Française d'Oncologie Pédiatrique for children with Burkitt lymphoma and L3 acute lymphoblastic leukemia.

Patients and methods: Treatment began with a prephase (low-dose steroids, vincristine and cyclophosphamide), except in patients with low tumor burden. Group A (resected stage I and abdominal stage II disease) received three courses of vincristine, cyclophosphamide, doxorubicin and prednisone. Group B (not eligible for groups A or C) received five courses of chemotherapy comprising high-dose methotrexate, infusional cytarabine and intrathecal (IT) methotrexate. Group C (patients with central nervous system and/or bone marrow involvement with <30% of blast cells) received eight courses containing intensified high-dose methotrexate, high-dose cytarabine, etoposide and triple IT injections.

Results: The 2 year event-free survival and overall survival rates for the 72 patients were 65% and 70%, respectively. Age ≥33 years and high lactate dehydrogenase value were associated with a shorter survival. No response to COP was also associated with a poor outcome in group B.

Conclusion: Patients with advanced-stage Burkitt lymphoma, including those with bone marrow and/or central nervous system involvement, can be cured with a short-term intensive chemotherapy regime tailored to the tumor burden.

Key words: adult patients, Burkitt lymphoma, chemotherapy, prognostic factors


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