Progressive or relapsed Burkitt lymphoma or leukemia in children and adolescents after BFM-type first-line therapy
Jazyk angličtina Země Spojené státy americké Médium print
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
31961927
DOI
10.1182/blood.2019003591
PII: S0006-4971(20)62135-8
Knihovny.cz E-zdroje
- MeSH
- analýza přežití MeSH
- Burkittův lymfom epidemiologie terapie MeSH
- dítě MeSH
- homologní transplantace MeSH
- lidé MeSH
- lokální recidiva nádoru epidemiologie terapie MeSH
- mladiství MeSH
- progrese nemoci MeSH
- protinádorové látky imunologicky aktivní terapeutické užití MeSH
- rituximab terapeutické užití MeSH
- transplantace hematopoetických kmenových buněk * MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- protinádorové látky imunologicky aktivní MeSH
- rituximab MeSH
Children with refractory or relapsed Burkitt lymphoma (BL) or Burkitt leukemia (B-AL) have a poor chance to survive. We describe characteristics, outcome, reinduction, and transplantation approaches and evaluate risk factors among children with progression of a BL/B-AL included in Non-Hodgkin's Lymphoma-Berlin-Frankfurt-Münster studies between 1986 and 2016. Treatment recommendation was reinduction including rituximab from the early 2000s followed by blood stem cell transplantation. The 3-year survival of the 157 children was 18.5 ± 3%. Survival significantly improved from 11 ± 3% before to 27 ± 5% after 2000 (P < .001), allowing for risk factor analyses among the latter 75 patients. Survival of 14 patients with relapse after initial therapy for low-risk disease (R1/R2) was 50 ± 13% compared with 21 ± 5% for 61 patients progressing after R3/R4 therapy (P < .02). A total of 25 of 28 patients with progression during first-line therapy, 31 of 32 with progression during reinduction, 15 of 16 not reaching a complete remission (CR) before transplantation, 9 of 10 treated with rituximab front-line, and all 13 patients not receiving rituximab during reinduction died. Forty-six patients received stem cell transplantation (20 autologous, 26 allogeneic). Survival after a regimen combining rituximab with continuous-infusion chemotherapy followed by allogeneic transplantation was 67 ± 12% compared with 18 ± 5% for all other regimen and transplantations (P = .003). Patients with relapsed BL/B-AL have a poor chance to survive after current effective front-line therapies. Progression during initial or reinduction chemotherapy and initial high-risk disease are risk factors in relapse. Time-condensed continuous-infusion reinduction followed by stem cell transplantation forms the basis for testing new drugs.
Department of Pediatric Hematology and Oncology Hannover Medical School Hannover Germany
Department of Pediatric Hematology and Oncology Justus Liebig University Giessen Germany
Pediatric Hematology and Oncology St Anna Children´s Hospital Vienna Austria
Pediatric Hematology and Oncology University Hospital Zurich Zurich Switzerland
Citace poskytuje Crossref.org
Genomic abnormalities of TP53 define distinct risk groups of paediatric B-cell non-Hodgkin lymphoma
