Dose-intensive chemotherapy including rituximab is highly effective but toxic in human immunodeficiency virus-infected patients with Burkitt lymphoma/leukemia: parallel study of 81 patients
Por:
Xicoy, B, Ribera, JM, Muller, M, Garcia, O, Hoffmann, C, Oriol, A, Hentrich, M, Grande, C, Wasmuth, JC, Esteve, J, van Lunzen, J, del Potro, E, Knechten, H, Brunet, S, Mayr, C, Escoda, L, Schommers, P, Alonso, N, Vall-Llovera, F, Perez, M, Morgades, M, Gonzalez, J, Fernandez, A, Thoden, J, Gokbuget, N, Hoelzer, D, Fatkenheuer, G, Wyen, C
Publicada:
1 oct 2014
Resumen:
The results of intensive immunochemotherapy were analyzed in human immunodeficiency virus (HIV)-related Burkitt lymphoma/leukemia (BLL) in two cohorts (Spain and Germany). Alternating cycles of chemotherapy were administered, with dose reductions for patients over 55 years. Eighty percent of patients achieved remission, 11% died during induction, 9% failed and 7% died in remission. Four-year overall survival (OS) and progression-free survival (PFS) probabilities were 72% (95% confidence interval [CI]: 62-82%) and 71% (95% CI: 61-81%). CD4 T-cell count < 200/mu L and bone marrow involvement were associated with poor OS (hazard ratio [HR] 3.2 [1.2-8.3] and HR 2.7 [1.1-6.6]) and PFS (HR 3.5 [1.3-9.1] and HR 2.4 [1-5.7]), bone marrow involvement with poor disease-free survival (DFS) (HR 14.4 [1.7-119.7] and Eastern Cooperative Oncology Group (ECOG) score > 2 (odds ratio [OR] 11.9 [1.4-99.9]) with induction death. In HIV-related BLL, intensive immunochemotherapy was feasible and effective, but toxic. Prognostic factors were performance status, CD4 T-cell count and bone marrow involvement.
Filiaciones:
Xicoy, B:
Univ Autonoma Barcelona, Inst Recerca Leucemia Josep Carreras, ICO Hosp Germans Trias & Pujol, Dept Clin Hematol, Badalona 08916, Spain
Ribera, JM:
Univ Autonoma Barcelona, Inst Recerca Leucemia Josep Carreras, ICO Hosp Germans Trias & Pujol, Dept Clin Hematol, Badalona 08916, Spain
Muller, M:
Vivantes Klinikum Neukolln, Dept Internal Med, Berlin, Germany
Garcia, O:
Univ Autonoma Barcelona, Inst Recerca Leucemia Josep Carreras, ICO Hosp Germans Trias & Pujol, Dept Clin Hematol, Badalona 08916, Spain
Hoffmann, C:
Hamburg Univ Schleswig Holstein, ICH Study Ctr, Hamburg, Germany
Oriol, A:
Univ Autonoma Barcelona, Inst Recerca Leucemia Josep Carreras, ICO Hosp Germans Trias & Pujol, Dept Clin Hematol, Badalona 08916, Spain
Hentrich, M:
Hosp Harlaching, Dept Hematol & Oncol, Munich, Germany
Grande, C:
Hosp Doce Octubre, Dept Hematol, Madrid, Spain
Wasmuth, JC:
Univ Bonn, Dept Internal Med 1, Bonn, Germany
Esteve, J:
Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
van Lunzen, J:
Univ Hamburg Eppendorf, Dept Internal Med, Hamburg, Germany
del Potro, E:
Hosp Clin San Carlos, Dept Hematol, Madrid, Spain
Knechten, H:
PZB, Aachen, Germany
Brunet, S:
Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
Mayr, C:
Arzteforum Seestr, Berlin, Germany
Escoda, L:
Hosp Joan 23, Dept Hematol, Tarragona, Spain
Schommers, P:
Univ Cologne, Dept Internal Med 1, D-50931 Cologne, Germany
Alonso, N:
Hosp Xeral Santiago de Compostela, Dept Hematol, Santiago De Compostela, Spain
Vall-Llovera, F:
Hosp Mutua Terrassa, Dept Hematol, Barcelona, Spain
Perez, M:
Hosp Virgen de la Concha, Dept Hematol, Zamora, Spain
Morgades, M:
Univ Autonoma Barcelona, Inst Recerca Leucemia Josep Carreras, ICO Hosp Germans Trias & Pujol, Dept Clin Hematol, Badalona 08916, Spain
Gonzalez, J:
Hosp Univ Virgen del Rocio, Dept Hematol, Seville, Spain
Fernandez, A:
Hosp Xeral CIES, Dept Hematol, Vigo, Spain
Thoden, J:
Univ Hosp Freiburg, Dept Internal Med, Freiberg, Germany
Gokbuget, N:
Goethe Univ Hosp, Dept Med 2, Dept Hematol, Frankfurt, Germany
Hoelzer, D:
Goethe Univ Hosp, Dept Med 2, Dept Hematol, Frankfurt, Germany
Fatkenheuer, G:
Univ Cologne, Dept Internal Med 1, D-50931 Cologne, Germany
Wyen, C:
Univ Cologne, Dept Internal Med 1, D-50931 Cologne, Germany
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