Burkitt lymphoma – no impact of HIV status on outcomes with rituximab-based chemoimmunotherapy

Abstract

We analyzed the prognostic factors for treatment outcomes amongst 34 patients with adult Burkitt lymphoma (BL) who received rituximab with standard first-line chemotherapy. Seven patients had human immunodeficiency virus (HIV)-associated BL. Overall, we observed a complete remission (CR) rate of 91.2%, and 10-year progression-free survival (PFS) and overall survival (OS) was 84.8 and 88.2%, respectively. In patients with concomitant HIV, the prognosis was not different with 10-year PFS of 100% and OS of 88.2%. The majority (71.4%) of HIV-associated BL patients received dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) and had excellent outcomes with 100% CR and no relapses. Central nervous system (CNS) disease, bone marrow involvement and elevated serum lactate dehydrogenase (LDH) levels more than 3 times upper limit of normal (ULN) were associated with poorer survival outcomes. Patients with refractory disease, whilst uncommon (n = 4), had dismal outcomes. Patients with adult BL, including HIV-related cases, harbor generally good prognosis in the modern era.

Keywords:

• Burkitt lymphoma
• human immunodeficiency virus
• bone marrow
• central nervous system

Acknowledgments

The authors thank all patients for their participation in this study.

Author contributions

JYT and TYQ analyzed the data and drafted the manuscript; JYT, TYQ, SYO, JBC, YHT, VSY, EWYC, EP, NS, MF, MT, STL, and JYC obtained patient data; JYT, TYQ, and JYC designed the study, interpreted the results, and revised the manuscript; and all authors read and approved the final version of the manuscript.

Disclosure statement

The authors report that they have no competing interests or financial disclosures to declare.

Additional information

Funding

This work was supported by the Tanoto Foundation Professorship in Medical Oncology, New Century Foundation Limited, Ling Foundation, Singapore Ministry of Health’s National Medical Research Council Research Training Fellowship under grant number 0054/2017; SHF-Foundation Research Grant under grant FG653P/2017; and SingHealth Duke-NUS Academic Medical Centre Oncology ACP Nurturing Clinician Scientist Scheme under grant 08-FY2017/P1/14-A28.