Journal article
Burkitt Lymphoma International Prognostic Index
Journal of clinical oncology, Vol.39(10), pp.1129-1138
2021
DOI: 10.1200/JCO.20.03288
PMCID: PMC9851706
PMID: 33502927
Abstract
PURPOSE: Burkitt lymphoma (BL) has unique biology and clinical course but lacks a standardized prognostic model. We developed and validated a novel prognostic index specific for BL to aid risk stratification, interpretation of clinical trials, and targeted development of novel treatment approaches. METHODS: We derived the BL International Prognostic Index (BL-IPI) from a real-world data set of adult patients with BL treated with immunochemotherapy in the United States between 2009 and 2018, identifying candidate variables that showed the strongest prognostic association with progression-free survival (PFS). The index was validated in an external data set of patients treated in Europe, Canada, and Australia between 2004 and 2019. RESULTS: In the derivation cohort of 633 patients with BL, age ≥ 40 years, performance status ≥ 2, serum lactate dehydrogenase > 3× upper limit of normal, and CNS involvement were selected as equally weighted factors with an independent prognostic value. The resulting BL-IPI identified groups with low (zero risk factors, 18% of patients), intermediate (one factor, 36% of patients), and high risk (≥ 2 factors, 46% of patients) with 3-year PFS estimates of 92%, 72%, and 53%, respectively, and 3-year overall survival estimates of 96%, 76%, and 59%, respectively. The index discriminated outcomes regardless of HIV status, stage, or first-line chemotherapy regimen. Patient characteristics, relative size of the BL-IPI groupings, and outcome discrimination were consistent in the validation cohort of 457 patients, with 3-year PFS estimates of 96%, 82%, and 63% for low-, intermediate-, and high-risk BL-IPI, respectively. CONCLUSION: The BL-IPI provides robust discrimination of survival in adult BL, suitable for use as prognostication and stratification in trials. The high-risk group has suboptimal outcomes with standard therapy and should be considered for innovative treatment approaches.
Details
- Title: Subtitle
- Burkitt Lymphoma International Prognostic Index
- Creators
- Adam J. Olszewski - Brown UniversityLasse H. Jakobsen - Aalborg UniversityGraham P. Collins - Oxford University Hospitals NHS TrustKate Cwynarski - University College London Hospitals NHS Foundation TrustVeronika Bachanova - University of MinnesotaKristie A. Blum - Emory UniversityKirsten M. Boughan - University Hospitals Seidman Cancer CenterMark Bower - Chelsea and Westminster HospitalAlessia Dalla Pria - Chelsea and Westminster HospitalAlexey Danilov - City Of Hope National Medical CenterKevin A. David - Rutgers, The State University of New JerseyCatherine Diefenbach - Perlmutter Cancer Institute, NYU Langone Health, New York, NY.Fredrik Ellin - Lund UniversityNarendranath Epperla - The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research InstituteUmar Farooq - University of IowaTatyana A. Feldman - Hackensack Meridian HealthAlina S. Gerrie - University of British ColumbiaDeepa Jagadeesh - Cleveland ClinicManali Kamdar - University of Colorado Cancer CenterReem Karmali - Northwestern UniversityShireen Kassam - King's College HospitalVaishalee P. Kenkre - University of Wisconsin Carbone Cancer CenterNadia Khan - Fox Chase Cancer CenterSeo Hyun Kim - Rush University Medical CenterAndreas K. Klein - Tufts Medical CenterIzidore S. Lossos - Sylvester Comprehensive Cancer CenterMatthew A. Lunning - University of Nebraska Medical CenterPeter Martin - NewYork–Presbyterian HospitalNicolas Martinez-Calle - Nottingham University Hospitals NHS TrustSilvia Montoto - Barts Health NHS TrustSeema Naik - Pennsylvania State UniversityNeil Palmisiano - Thomas Jefferson UniversityDavid Peace - University of Illinois Urbana-ChampaignElizabeth H. Phillips - University of ManchesterTycel J. Phillips - University of Michigan Comprehensive Cancer Center, Dexter, MI.Craig A. Portell - University of VirginiaNishitha Reddy - Vanderbilt University Medical CenterAnna Santarsieri - Cambridge University Hospitals NHS Foundation TrustKnut B. Smeland - Oslo University HospitalScott E. Smith - Loyola University Medical CenterStephen D. Smith - Fred Hutch Cancer CenterSuchitra Sundaram - Roswell Park Cancer InstituteAdam S. Zayac - Brown UniversityXiao Yin Zhang - Oxford University Hospitals NHS TrustCatherine Zhu - University College London Hospitals NHS Foundation TrustChan Y. Cheah - Sir Charles Gairdner HospitalTarec C. El-Galaly - Aalborg University HospitalAndrew M. Evens - Rutgers, The State University of New JerseyBurkitt Lymphoma Inte Prognostic
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.39(10), pp.1129-1138
- DOI
- 10.1200/JCO.20.03288
- PMID
- 33502927
- PMCID
- PMC9851706
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359877202771
Metrics
14 Record Views