Feasibility and outcomes after dose reduction of immunochemotherapy in young adults with Burkitt lymphoma and leukemia : results of the BURKIMAB14 trial
Ribera, Josep Maria (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Morgades, Mireia (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Garcia-Calduch, Olga (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Sirvent, Maialen (Hospital Universitario de Donostia)
Buendia, Buenaventura (Hospital Universitario 12 de Octubre)
Cervera, Marta (Institut Catala d'Oncologia-Hospital Joan XXIII)
Luzardo, Hugo (Hospital Universitario de Gran Canaria Dr. Negrin)
Hernandez-Rivas, Jesus Maria (Hospital Universitario de Salamanca)
Sitges, Marta (Hospital Universitari de Girona Doctor Josep Trueta)
Garcia-Cadenas, Irene (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Abrisqueta, Pau (Hospital Universitari Vall d'Hebron)
Montesinos, Pau (Hospital Universitari i Politècnic La Fe (València))
Bastos-Oreiro, Mariana (Hospital General Universitario Gregorio Marañón)
De Llano, Maria Paz Queipo (Hospital Universitario Virgen de la Victoria (Màlaga, Andalusia))
Bravo, Pilar (Hospital Universitario de Fuenlabrada. Madrid)
Torrent, Anna (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Herrera, Pilar (Hospital Universitario Ramon y Cajal)
Garcia-Guinon, Antonni (Hospital Universitari Arnau de Vilanova)
Vall-Llovera, Ferran (Hospital Universitari MútuaTerrassa)
Serrano, Josefina (Hospital Universitario Reina Sofía (Córdoba, Espanya))
Terol, Maria José (Hospital Clínic Universitari (València))
Bergua, Juan Miguel (Hospital San Pedro de Alcántara)
Garcia-Noblejas, Ana (Hospital Universitario de La Princesa)
Barrenetxea, Cristina (Hospital Universitario Basurto)
Llorente, Laura (Hospital Universitario HM Sanchinarro (Madrid))
Garcia-Belmonte, Daniel (Hospital Universitario La Zarzuela)
Gimeno, Eva (Hospital del Mar (Barcelona, Catalunya))
Cladera, Antonia (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Mercadal, Santiago (Institut Català d'Oncologia)
Sancho, Juan Manuel (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)

Data:	2024
Resum:	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).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Aged ; Antineoplastic Combined Chemotherapy Protocols ; Burkitt Lymphoma ; Cyclophosphamide ; Doxorubicin ; Drug Tapering ; Feasibility Studies ; HIV Infections ; Humans ; Leukemia ; Middle Aged ; Prospective Studies ; Rituximab ; Young Adult
Publicat a:	Haematologica, Vol. 109 Núm. 2 (january 2024) , p. 543-552, ISSN 1592-8721

DOI: 10.3324/haematol.2023.283342
PMID: 37560813

10 p, 3.3 MB

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