Intensive chemotherapy with cyclophosphamide, doxorubicin, high‐dose methotrexate/ifosfamide, etoposide, and high‐dose cytarabine (CODOX‐M/IVAC) for human immunodeficiency virus–associated Burkitt lymphoma

Wang, Eunice S.; Straus, David J.; Teruya‐Feldstein, Julie; Qin, Jing; Portlock, Carol S.; Moskowitz, Craig H.; Goy, André; Hedrick, Eric; Zelenetz, Andrew D.; Noy, Ariela

doi:10.1002/cncr.11628

Cited by 147 publications

(96 citation statements)

References 35 publications

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“…One study showed a median survival of only 6 months. 133 However, a retrospective analysis by Wang et al 134 reported that HIV-positive and -negative patients with Burkitt's lymphoma had similar outcomes when treated with CODOX-M/IVAC.…”

Section: Treatmentmentioning

confidence: 99%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

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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: 99%

Non-Hodgkin’s Lymphomas

Ad¹,

Js²,

Rh³

et al. 2010

J Natl Compr Canc Netw

Self Cite

223

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“…3 Finally, retrospective analyses suggest that HAART era HIV-positive BL patients do poorly with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) -like regimens, 17 but may do well with intensive regimens. 18 Nonetheless, because of the perceived risk of increased hematologic and infectious complications, many patients with HIV-associated BL continue to be treated with CHOP and other moderate-dose chemotherapy despite inferiority in HIV-negative BL patients.…”

Section: Introductionmentioning

confidence: 99%

AMC 048: modified CODOX-M/IVAC-rituximab is safe and effective for HIV-associated Burkitt lymphoma

Noy

Lee

Cesarman

et al. 2015

Blood

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• We report the first dedicated prospective study in HIV-Burkitt lymphoma demonstrating safety and efficacy in a multiinstitutional setting.• We offer a new therapeutic option by modifying an existing regimen and making it much less toxic.The toxicity of dose-intensive regimens used for Burkitt lymphoma prompted modification of cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate/ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC) for HIV-positive patients. We added rituximab, reduced and/or rescheduled cyclophosphamide and methotrexate, capped vincristine, and used combination intrathecal chemotherapy. Antibiotic prophylaxis and growth factor support were required; highly active antiretroviral therapy (HAART) was discretionary. Thirteen AIDS Malignancy Consortium centers enrolled 34 patients from 2007 to 2010. Median age was 42 years (range, 19-55 years), 32 of 34 patients were high risk, 74% had stage III to IV BL and CD4 count of 195 cells per mL (range, 0-721 cells per mL), and 5 patients (15%) had CD4 <100 cells per mL. Twenty-six patients were receiving HAART; viral load was <100 copies per mL in 12 patients. Twenty-seven patients had at least one grade 3 to 5 toxicity, including 20 hematologic, 14 infectious, and 6 metabolic. None had grade 3 to 4 mucositis. Five patients did not complete treatments because of adverse events. Eleven patients died, including 1 treatment-related and 8 disease-related deaths. The 1-year progressionfree survival was 69% (95% confidence interval [CI], 51%-82%) and overall survival was 72% (95% CI, 53%-84%); 2-year overall survival was 69% (95% CI, 50%-82%). Modifications of the CODOX-M/IVAC regimen resulted in a grade 3 to 4 toxicity rate of 79%, which was lower than that in the parent regimen (100%), without grade 3 to 4 mucositis. Despite a 68% protocol completion rate, the 1-year survival rate compares favorably with 2 studies that excluded HIV-positive patients. This trial was registered at http:// clinicaltrials.gov as #NCT00392834. (Blood. 2015;126(2):160-166)

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“…While an increasing number of patients with ARL are successfully treated with standard chemotherapies such as cyclophosphamide hydroxydoxorubicin, oncovin, prednisone (CHOP), there is little experience with more aggressive protocols [10]. Previous experience has shown very poor response rates in patients with AIDS-related Burkitt's lymphoma treated with CHOP [11].…”

Section: Discussionmentioning

confidence: 99%

Successful administration of aggressive chemotherapy concomitant to tuberculostatic and highly active antiretroviral therapy in a patient with AIDS‐related Burkitt's lymphoma

et al. 2005

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Treatment of AIDS‐related malignant lymphoma (ARL) remains a therapeutic challenge. There are concerns not only about infectious and haematological complications in HIV‐infected patients during intensive chemotherapy, but also about potential interactions between chemotherapy and highly active antiretroviral therapy (HAART). Current data on patients treated concomitantly with intensive chemotherapy and HAART are limited, and no data exist on patients with ARL suffering from active opportunistic infections. We report the case of a 38‐year‐old man with advanced HIV‐1 infection, pulmonary tuberculosis and Burkitt's lymphoma. Intensive chemotherapy was administered in parallel with tuberculostatic therapy and HAART. Six months later, the patient achieved not only a complete remission of Burkitt's lymphoma and sustained viral suppression, but also a full recovery from tuberculosis. This case report provides some useful observations on the successful application of intensive chemotherapy in addition to tuberculostatic therapy and HAART in HIV‐infected patients.

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Intensive chemotherapy with cyclophosphamide, doxorubicin, high‐dose methotrexate/ifosfamide, etoposide, and high‐dose cytarabine (CODOX‐M/IVAC) for human immunodeficiency virus–associated Burkitt lymphoma

Cited by 147 publications

References 35 publications

Non-Hodgkin’s Lymphomas

Non-Hodgkin’s Lymphomas

AMC 048: modified CODOX-M/IVAC-rituximab is safe and effective for HIV-associated Burkitt lymphoma

Successful administration of aggressive chemotherapy concomitant to tuberculostatic and highly active antiretroviral therapy in a patient with AIDS‐related Burkitt's lymphoma

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