Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis
Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis
复制标题
DOI：
10.1093/annonc/mdq677
复制
发表时间：
2011-08-01
影响因子：
50.5
通讯作者：
Abramson, J. S.
中科院分区：
文献类型：
--
作者：
Barnes, J. A.;LaCasce, A. S.;Abramson, J. S.
背景：Burkitt‘s淋巴瘤是一种高度侵袭性的B细胞性非霍奇金淋巴瘤，可通过强化化疗治愈。在CODOX-M/IVAC(环磷酰胺、长春新碱、阿霉素和大剂量甲氨蝶呤，与异环磷酰胺、依托泊苷和阿糖胞苷交替使用)中添加CD20导向的单抗利妥昔单抗尚未被研究，尽管对其他侵袭性CD20阳性的NHL有效。结果：接受利妥昔单抗治疗的患者复发率较低(3/40比13/40，P=0.01)。支持利妥昔单抗治疗的结果有改善的趋势，3年PFS(74%对61%)和3年OS(77%对66%)，尽管这些没有达到统计学意义。多因素COX回归分析、治疗调整、人类免疫缺陷病毒(HIV)感染、高危人群中，高龄和中枢神经系统受累与OS差相关。结论：CODOX-M/IVAC联合或不联合利妥昔单抗治疗成人BL是一种高效的治疗方案。利妥昔单抗降低复发率，并有改善PFS和OS的趋势。感染艾滋病毒的患者取得了与未感染艾滋病毒的患者相当的结果。
Background: Burkitt's lymphoma (BL) is a highly aggressive B-cell non-Hodgkin's lymphoma (NHL) that may be cured with intensive chemotherapy. The addition of the CD20-directed monoclonal antibody rituximab to CODOX-M/IVAC (cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate, alternating with ifosfamide, etoposide, and cytarabine) has not been studied despite efficacy in other aggressive CD20-positive NHLs.Patients and methods: Eighty adult BL patients treated with or without rituximab were identified at our institutions. Response rate, overall survival (OS), and progression-free survival (PFS) are calculated.Results: There were fewer relapses in rituximab-treated patients (3 of 40 versus 13 of 40, P = 0.01). There was a trend for improvement in outcome favoring rituximab-containing therapy, with 3-year PFS (74% versus 61%) and 3-year OS (77% versus 66%), although these did not reach statistical significance. Advanced age and central nervous system involvement were associated with poorer OS on multivariable Cox regression analysis, adjusting for treatment, human immunodeficiency virus (HIV) involvement, and risk group.Conclusions: CODOX-M/IVAC, with or without rituximab, is a highly effective regimen for the treatment of adult BL. Rituximab decreased the recurrence rate and showed a trend in favor of improvement in PFS and OS. HIV-infected patients achieved outcomes comparable with those of their non-HIV-infected counterparts.