High-dose chemotherapy and immunotherapy in adult Burkitt lymphoma: Comparison of results in human immunodeficiency virus-infected and noninfected patients

Albert Oriol, Josep Maria Ribera, Juan Bergua, Eduardo Giménez Mesa, Carlos Grande, Jordi Esteve, Salut Brunet, Maria Jose Moreno, Lourdes Escoda, Jesus Maria Hernandez-Rivas, Dieter Hoelzer

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93 Citations (Scopus)

Abstract

BACKGROUND. It has been recognized that cure is possible for human immunodeficiency virus (HIV)-infected patients with Burkitt lymphoma/leukemia (BL) if appropriate chemotherapy is used. The introduction of rituximab in BL therapeutic schemes has been scarcely explored. The outcome and toxicity of HIV-positive patients with BL treated in a rituximab and intensive chemotherapy-based trial was evaluated. METHODS. Thirty-six consecutive patients, 15 to 55 years of age, diagnosed with advanced stage BL were recruited from July 2003 to August 2006, stratified according to HIV infection status and treated with 6 cycles of intensive chemotherapy including 8 doses of rituximab. RESULTS. Nineteen of the patients (53%) were HIV-infected. Their clinical characteristics were comparable to those of the HIV-negative patients. Complete remission (CR) rates were 88% and 84%, respectively, for HIV-negative and -positive patients. Twenty-seven patients (82% and 68%, respectively, for HIV-negative and -positive patients) completed the 6 protocol scheduled cycles. HIV-infected patients presented higher incidences of grade 3-4 mucositis (27% vs 7% of cycles, P = .0005) and severe infectious episodes (26% vs 8%, P = .0025). However, there were no statistically significant differences in 2-year overall survival (82%, 95% confidence interval [CI], 65%-99% and 73%, 95% CI, 54%-92%, respectively) or 2-year disease-free survival (93%, 95% CI, 82%-99% and 87%, 95% CI 72%-99%, respectively). CONCLUSIONS. Intensive immunochemotherapy can be administered safely to patients with HIV infection. Despite a higher incidence of severe mucositis and infections the remission and survival rates are comparable to those observed in HIV-negative patients. © 2008 American Cancer Society.
Original languageEnglish
Pages (from-to)117-125
JournalCancer
Volume113
Issue number1
DOIs
Publication statusPublished - 1 Jul 2008

Keywords

  • Burkitt lymphoma/leukemia
  • HIV infection
  • Immunochemotherapy
  • Toxicity and outcome

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