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

  • Blanca Xicoy
  • Josep-Maria Ribera
  • Markus Müller
  • Olga García
  • Christian Hoffmann
  • Albert Oriol
  • Marcus Hentrich
  • Carlos Grande
  • Jan-Christian Wasmuth
  • Jordi Esteve
  • Jan van Lunzen
  • Eloy Del Potro
  • Heribert Knechten
  • Salut Brunet
  • Christoph Mayr
  • Lourdes Escoda
  • Philipp Schommers
  • Natalia Alonso
  • Ferran Vall-Llovera
  • Montserrat Pérez
  • Mireia Morgades
  • José González
  • Angeles Fernández
  • Jan Thoden
  • Nicola Gökbuget
  • Dieter Hoelzer
  • Gerd Fätkenheuer
  • Christoph Wyen
  • PETHEMA Group and German HIV Lymphoma Cohort

Related Research units

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.

Bibliographical data

Original languageEnglish
ISSN1042-8194
DOIs
Publication statusPublished - 25.02.2014
PubMed 24397614