Progressive or relapsed Burkitt lymphoma or leukemia in children and adolescents after BFM-type first-line therapy
Language English Country United States Media print
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
31961927
DOI
10.1182/blood.2019003591
PII: S0006-4971(20)62135-8
Knihovny.cz E-resources
- MeSH
- Survival Analysis MeSH
- Burkitt Lymphoma epidemiology therapy MeSH
- Child MeSH
- Transplantation, Homologous MeSH
- Humans MeSH
- Neoplasm Recurrence, Local epidemiology therapy MeSH
- Adolescent MeSH
- Disease Progression MeSH
- Antineoplastic Agents, Immunological therapeutic use MeSH
- Rituximab therapeutic use MeSH
- Hematopoietic Stem Cell Transplantation * MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Antineoplastic Agents, Immunological 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
References provided by Crossref.org
Genomic abnormalities of TP53 define distinct risk groups of paediatric B-cell non-Hodgkin lymphoma
