Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial

Ribrag, Vincent; Koscielny, Serge; Bosq, Jacques; Leguay, Thibaut; Casasnovas, Olivier; Fornecker, L.; Récher, Christian; Ghesquières, Hervé; Morschhauser, Franck; Girault, Stéphane; Gouill, Steven Le; Ojeda-Uribe, Mario; Mariette, Clara; Cornillon, Jérôme; Cartron, Guillaume; Vergé, Veronique; Chassagne‐Clément, Catherine; Dombret, Hervé; Coiffier, Bertrand; Lamy, Thierry; Tilly, Hervé; Salles, Gilles

doi:10.1016/s0140-6736(15)01317-3

Cited by 164 publications

(131 citation statements)

References 27 publications

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“…The French study randomizing 260 patients to chemotherapy with or without rituximab reported therapeutic results for patients <40 vs >40 years (AYAs 38%). In univariate analysis, regardless of rituximab therapy, EFS and OS of 101 AYAs were statistically better than the figures observed in older patients ( P <0.0001) 98. Therefore, with modern rituximab-based BL regimens, the expectation is to cure 85%–90% of AYAs in the 15–40 years age range, with a low incidence of failures related to either resistant/progressive disease or treatment complications.…”

Section: Aya Vs Adult Resultsmentioning

confidence: 81%

“…83,98–101 Two no-rituximab study are of historical interest only. With rituximab, the GMALL reported significant outcome difference between AYAs aged 15–25 years, adults between 26 and 55 years, and older patients (OS 90%, 84%, and 62%, respectively) 83.…”

Section: Aya Vs Adult Resultsmentioning

confidence: 99%

“…This type of treatment has not yet been tested in adolescents and children. The role of additional rituximab in BL was conclusively demonstrated by a phase III trial from France,98 also reporting separately the more favorable outcome of AYAs <40 years compared to older patients (described in the “AYA vs adult results” section).…”

Section: Improving Bl Therapy With Rituximabmentioning

confidence: 92%

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Burkitt lymphoma in adolescents and young adults: management challenges

Dozzo¹,

Carobolante²,

Donisi³

et al. 2016

AHMT

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About one-half of all Burkitt lymphoma (BL) patients are younger than 40 years, and one-third belong to the adolescent and young adult (AYA) subset, defined by an age between 15 and 25–40 years, based on selection criteria used in different reports. BL is an aggressive B-cell neoplasm displaying highly characteristic clinico-diagnostic features, the biologic hallmark of which is a translocation involving immunoglobulin and c-MYC genes. It presents as sporadic, endemic, or epidemic disease. Endemicity is pathogenetically linked to an imbalance of the immune system which occurs in African children infected by malaria parasites and Epstein–Barr virus, while the epidemic form strictly follows the pattern of infection by HIV. BL shows propensity to extranodal involvement of abdominal organs, bone marrow, and central nervous system, and can cause severe metabolic and renal impairment. Nevertheless, BL is highly responsive to specifically designed short-intensive, rotational multiagent chemotherapy programs, empowered by the anti-CD20 monoclonal antibody rituximab. When carefully applied with appropriate supportive measures, these modern programs achieve a cure rate of approximately 90% in the average AYA patient, irrespective of clinical stage, which is the best result achievable in any aggressive lymphoid malignancy to date. The challenges ahead concern the following: optimization of management in underdeveloped countries, with reduction of diagnostic and referral-for-care intervals, and the applicability of currently curative regimens; the development of lower intensity but equally effective treatments for frail or immunocompromised patients at risk of death by complications; the identification of very high-risk patients through positron-emission tomography and minimal residual disease assays; and the assessment in these and the few refractory/relapsed ones of new monoclonals (ofatumumab, blinatumomab, inotuzumab ozogamicin) and new molecules targeting c-MYC and key proliferative steps of B-cell malignancies.

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Section: Aya Vs Adult Resultsmentioning

confidence: 81%

Section: Aya Vs Adult Resultsmentioning

confidence: 99%

Section: Improving Bl Therapy With Rituximabmentioning

confidence: 92%

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Burkitt lymphoma in adolescents and young adults: management challenges

Dozzo¹,

Carobolante²,

Donisi³

et al. 2016

AHMT

View full text Add to dashboard Cite

show abstract

“…[4, 5] Despite the high cure rate in the frontline setting, patients who are refractory to initial treatment failure have a poor prognosis. [6] Few studies however have systematically evaluated outcomes of adults with relapsed/refractory disease or the efficacy of salvage chemotherapy in this setting.…”

Section: To the Editormentioning

confidence: 99%

Outcomes of adults with relapsed or refractory Burkitt and high‐grade B‐cell leukemia/lymphoma

Short

Kantarjian

et al. 2017

American J Hematol

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“…The addition of rituximab to hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate, and cytarabine (hyper-CVAD) regimen (8 infusions) resulted in a 3-year survival rate of 89% compared with 53% with chemotherapy alone. 6 Ribrag et al 9 conducted an open-label randomized phase 3 trial comparing chemotherapy alone (n 5 129) with chemotherapy plus rituximab (n 5 128). Rituximab (375 mg/m 2 ) was given on days 1 and 6 during the first 2 courses of chemotherapy (total of 4 infusions).…”

Section: Anti-cd20 Antibodiesmentioning

confidence: 99%