Abstract |
Burkitt leukemia/ lymphoma (BL) and high-grade B-cell lymphoma (HGBL) have a high incidence of central nervous system (CNS) involvement, which is associated with poor prognosis. The hyper- cyclophosphamide, vincristine, Adriamycin, and dexamethasone plus rituximab (CVAD-R) regimen includes systemic and intrathecal CNS-directed therapy to treat and prevent CNS disease. We report here the long-term safety and efficacy of the hyper-CVAD-R regimen in adults with BL and HGBL, focusing on its efficacy to prevent CNS relapse. Among 79 adults (54 BL, 25 HGBL), the median age was 44 years (25% ≥60 years old), 73% had bone marrow (BM) involvement, and 28% had CNS involvement. The complete response rate was 91% (BL 96%; HGBCL 79%; P = .16). The 5-year relapse-free survival (RFS) and overall survival (OS) rates were 58% and 52%, respectively. The cumulative incidence of relapse (CIR) was 21% ( BL 14%; HGBCL 37%, P = .06) and was associated with baseline BM (27% vs 0%; P = .02) and CNS (42% vs 12%; P < .01) involvement. In multivariate analyses, age and CNS involvement were independent predictors for OS and RFS. The 5-year CNS CIR was 6% (BL 4%; HGBL 11%; P = .31); 16% with baseline CNS involvement (P = .03). Our data support the use of hyper-CVAD-R in preventing CNS relapse, especially among high-risk patients with BM or CNS involvement.
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Authors | Bachar Samra, Joseph D Khoury, Kiyomi Morita, Farhad Ravandi, Guillaume Richard-Carpentier, Nicholas J Short, Siba El Hussein, Philip Thompson, Nitin Jain, Hagop Kantarjian, Elias Jabbour |
Journal | Blood advances
(Blood Adv)
Vol. 5
Issue 20
Pg. 3913-3918
(10 26 2021)
ISSN: 2473-9537 [Electronic] United States |
PMID | 34464974
(Publication Type: Journal Article)
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Copyright | © 2021 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. |
Chemical References |
- Vincristine
- Dexamethasone
- Doxorubicin
- Cyclophosphamide
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Topics |
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Burkitt Lymphoma
(drug therapy)
- Cyclophosphamide
(therapeutic use)
- Dexamethasone
(therapeutic use)
- Doxorubicin
(therapeutic use)
- Humans
- Middle Aged
- Recurrence
- Vincristine
(therapeutic use)
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