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Research Article

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

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Pages 2341-2348 | Received 21 Aug 2013, Accepted 20 Dec 2013, Published online: 25 Feb 2014
 

Abstract

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/μL 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.

Acknowledgements

The following investigators from the PETHEMA group and GESIDA (Grupo de Estudio del Sida) have participated in the study.

German HIV Lymphoma Cohort (12 centers)

Christian Hoffmann (Hamburg), Gerd Fätkenheuer (Köln), Christoph Wyen (Köln), Marcus Hentrich (München), Heribert Knechten (Aachen), Christoph Mayr (Berlin), Markus Müller (Berlin), Thomas Sternfeld, Roger Vogelmann (München), Jan Thoden (Freiburg), Jan van Lunzen (Hamburg), Jan-Christian Wasmuth, Jürgen Rockstroh (Bonn), Timo Wolf, Dieter Hoelzer (Frankfurt), Angela Hammond (Augsburg), Bernhard Schaaf (Lübeck).

Spanish PETHEMA Group and GESIDA (12 centers)

Pilar Miralles (Madrid), M. Pérez-Sánchez (Zamora), Albert Esquirol Sanfeliu (Barcelona), Eugenio Giménez Mesa (Madrid), Francisco Fernández Débora (Madrid), Maria-Pilar Martínez (Madrid), Sonia González (Santiago de Compostela), Juan Berenguer (Madrid), Alejandra Martínez (Barcelona), Mónica Sánchez (Madrid), Andreu Llorente (Tarragona), Blanca Xicoy (Badalona), Josep-Maria Ribera (Badalona), Olga García (Badalona), Albert Oriol (Badalona), Carlos Grande (Madrid), Jordi Esteve (Barcelona), Eloy del Potro (Madrid), Salut Brunet (Barcelona), Lourdes Escoda (Tarragona), Natalia Alonso (Santiago de Compostela), Ferran Vall-llovera (Terrassa), Montserrat Pérez (Zamora), Mireia Morgades (Badalona), José González (Sevilla), Ángeles Fernández (Vigo).

GMALL Study Group

Nicola Gökbuget, Dieter Hoelzer (Frankfurt).

Funding

This study was supported in part by the José Carreras Leukämie-Stiftung e.V. Cooperation project DJCLS H 06/03 (GMALL-PETHEMA) and RD06/0020/1056 from the RTICC, Intituto de Salud Carlos III, Spain and by the German Federal Ministry of Education and Research (BMBF), Grant 01 KI 0771.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

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