Hyper-CVAD and rituximab therapy in HIV-Negative Burkitt (BL) or Burkitt-like (BLL) leukemia/lymphoma and mature B-cell acute lymphocytic leukemia (B-ALL)

Thomas, D. A.; Cortés, Jorge Alberto; O’Brien, Stephen G.; Giles, Francis J.; Pierce, Sherry; Kantarjian, Hagop

doi:10.1200/jco.2005.23.16_suppl.6531

Cited by 7 publications

(6 citation statements)

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“…104 In the updated report, with a median follow-up of 46 months, 4-year overall survival rates (75% vs. 50%) and overall survival rates in patients younger than 60 (76% vs. 70% ) and those 60 years or older (72% vs. 19%) were superior for hyperCVAD with rituximab, in historical comparison with patients treated with hyperCVAD alone. 105 The results of this study showed that the addition of rituximab to hyper-CVAD improves long-term outcome, particularly in elderly patients.…”

Section: Treatmentmentioning

confidence: 73%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

223

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OverviewNon-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer (NK) lymphocytes. In the United States, B-cell lymphomas represent 80% to 85% of all cases, with 15% to 20% being T-cell lymphomas; NK lymphomas are very rare. In 2009, an estimated 65,980 new cases of NHL will be diagnosed and 19,500 will die of the disease.1 NHL is the sixth leading site of new cancer cases among men and fifth among women, accounting for 4% to 5% of new cancer cases and 3% to 4% of cancer-related deaths. Non-Hodgkin's Lymphomas Clinical Practice Guidelines in OncologyKey Words NCCN Clinical Practice Guidelines, non-Hodgkin's lymphoma, chronic lymphocytic leukemia, follicular lymphoma, diffuse large B-cell lymphoma, mantle cell lymphoma, peripheral T-cell lymphoma, cutaneous T-cell lymphoma, mycosis fungoides, Sézary syndrome, marginal zone lymphoma, mucosaassociated lymphoid tissue lymphoma, diagnosis, treatment, hematopathology, immunohistochemistry, treatment guidelines, staging evaluation, lymphoma pathology (JNCCN 2010;8:288-334) NCCN Categories of Evidence and ConsensusCategory 1: The recommendation is based on high-level evidence (e.g., randomized controlled trials) and there is uniform NCCN consensus. Category 2A: The recommendation is based on lowerlevel evidence and there is uniform NCCN consensus. Category 2B: The recommendation is based on lowerlevel evidence and there is nonuniform NCCN consensus (but no major disagreement). Category 3: The recommendation is based on any level of evidence but reflects major disagreement. Please NoteThese guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no representation or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their applications or use in any way.These guidelines are copyrighted by the National Comprehensive Cancer Network. All rights reserved. These guidelines and the illustrations herein may not be reproduced in any form without the express written permission of the NCCN © 2010. Disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines PanelAt the beginning of each NCCN guidelines panel meeting, panel members disclosed any financial support they have received from industry. Through 2008, this information was published in an aggregate statement in JNCCN and online. Furthering NCCN's commitment to public transparency, this disclosure process has now been expanded by listing all potential conflicts of interest respective to each individual expert panel member.Individual disclosures for the NCCN Non-Hodgkin's Lymphomas Guidelines Panel members can be found on page 334. (To view the most recent version of these guideli...

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Section: Treatmentmentioning

confidence: 73%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

223

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“…At the present time, there is no accepted standard of treatment for adult BL or BLL, but there are several reasonable strategies (4)(5)(6)(7)(8)(12)(13)(14)(15)(16). Some of these regimens were extrapolated from pediatric ALL regimens, utilizing multiple drugs given over a protracted course of time, with modest dose intensity.…”

Section: Discussionmentioning

confidence: 98%

“…This group later modified the regimen to include rituximab and to administer the treatment in laminar air flow rooms. Data on 31 patients was presented at the 2005 American Society of Clinical Oncology (16). The overall response rate was 91 percent and no induction deaths were observed.…”

Section: Discussionmentioning

confidence: 99%

A 5-Drug Regimen Maximizing the Dose of Cyclophosphamide is Effective Therapy for Adult Burkitt or Burkitt-like Lymphomas

Kujawski

Longo

Williams

et al. 2007

Cancer Investigation

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Burkitt lymphoma (BL) and Burkitt-like lymphomas (BLL) are clinically and biologically aggressive B-cell malignancies. Brief-duration, high intensity multidrug regimens with central nervous system (CNS) prophylaxis have proven to be effective, with published series of adult patients documenting complete response (CR) rates of 80 to 100 percent and 2-year event-free survival (EFS) rates ranging from 60 to 90 percent. Based upon the known sensitivity of BL to cyclophosphamide and favorable results reported from the Dana Farber Cancer Center using high-dose CHOP in diffuse aggressive lymphomas, we tested a regimen designed to maximize the administered dose of cyclophosphamide while eliminating other agents commonly used in BL protocols. Eleven patients with Burkitt or Burkitt-like lymphoma were treated with 4 cycles of a 5-drug regimen, called high-dose CHOP, which contains a cyclophosphamide dose of 4 gm/m2 with each cycle. Intrathecal methotrexate and midcycle high-dose methotrexate were added as CNS prophylaxis. Ten patients achieved a complete response (91 percent) and with a median follow up of 38 months, the 3-year EFS is 64 percent and the 3-year overall survival (OS) is 72 percent. Three patients recurred after the achievement of a CR. Treatment-related toxicities included myelosuppression, neutropenic fevers/infections, and tumor lysis syndrome requiring hemodialysis in 2 patients. There were no treatment-related deaths and none of the patients had to discontinue therapy secondary to toxicity. In conclusion, the high-dose CHOP with midcycle methotrexate regimen produces response rates and EFS rates comparable to other regimens, with an acceptable toxicity profile. Utilization of high dose cyclophosphamide may eliminate the need for several other agents in Burkitt lymphoma regimens.

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“…In patients with B-ALL that express CD20, the addition of the anti-CD20 monoclonal antibody rituximab to chemotherapy, might increase the survival rate by 20% to 30% to approximately 80%. 44,45 In these patients, relapse tends to occur within the first year and a half after achieving remission. There are no validated prognostic factors that predict relapse.…”

Section: Cellular Therapy Of All 121mentioning

confidence: 99%