Journal article
Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers
Blood, Vol.137(3), pp.374-386
01/21/2021
DOI: 10.1182/blood.2020006926
PMCID: PMC8765121
PMID: 32663292
Abstract
We examined adults with untreated Burkitt lymphoma (BL) from 2009 to 2018 across 30 US cancer centers. Factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Among 641 BL patients, baseline features induded the following: median age, 47 years; HIV+, 22%; Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 to 4, 23%; >1 extranodal site, 43%; advanced stage, 78%; and central nervous system (CNS) involvement, 19%. Treatment-related mortality was 10%, with most common causes being sepsis, gastrointestinal bleed/perforation, and respiratory failure. With 45-month median follow-up, 3-year PFS and OS rates were 64% and 70%, respectively, without differences by HIV status. Survival was better for patients who received rituximab vs not (3-year PFS, 67% vs 38%; OS, 72% vs 44%; P < .001) and without difference based on setting of administration (ie, inpatient vs outpatient). Outcomes were also improved at an academic vs community cancer center (3-year PFS, 67% vs 46%, P = .006; OS, 72% vs 53%, P = .01). In multivariate models, age >= 40 years (PFS, hazard ratio [HR] = 1.70, P = .001; OS, HR = 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR = 1.60, P < .001; OS, HR = 1.74, P = .003), lactate dehydrogenase > 3x normal (PFS, HR = 1.83, P < .001; OS, HR = 1.63, P = .009), and CNS involvement (PFS, HR = 1.52, P = .017; OS, HR = 1.67, P = .014) predicted inferior survival. Furthermore, survival varied based on number of factors present (0, 1, 2 to 4 factors) yielding 3-year PFS rates of 91%, 73%, and 50%, respectively; and 3-year OS rates of 95%, 77%, and 56%, respectively. Collectively, outcomes for adult BL in this real-world analysis appeared more modest compared with results of clinical trials and smaller series. In addition, clinical prognostic factors at diagnosis identified patients with divergent survival rates.
Details
- Title: Subtitle
- Burkitt lymphoma in the modern era: real-world outcomes and prognostication across 30 US cancer centers
- Creators
- Andrew M. Evens - Rutgers, The State University of New JerseyAlexey Danilov - Oregon Health & Science UniversityDeepa Jagadeesh - Cleveland ClinicAmy Sperling - Fred Hutch Cancer CenterSeo-Hyun Kim - Rush UniversityRyan Vaca - Pennsylvania State UniversityCatherine Wei - Rutgers, The State University of New JerseyDaniel Rector - Rutgers, The State University of New JerseySuchitra Sundaram - Roswell Park Cancer InstituteNishitha Reddy - Vanderbilt UniversityYong Lin - Rutgers, The State University of New JerseyUmar Farooq - University of IowaChristopher D'Angelo - University of Wisconsin–MadisonDavid A. Bond - The Ohio State UniversityStephanie Berg - Loyola University ChicagoMichael C. Churnetski - Emory UniversityAmandeep Godara - Tufts UniversityNadia Khan - Fox Chase Cancer CenterYun Kyong Choi - New York University School of MedicineEmma Rabinovich - University of Illinois ChicagoGaurav Varma - NewYork–Presbyterian HospitalReem Karmali - Northwestern UniversityAgrima Mian - Cleveland ClinicMalvi Savani - University of MinnesotaMadelyn Burkart - Northwestern UniversityPeter Martin - NewYork–Presbyterian HospitalAlbert Ren - University of Illinois ChicagoAyushi Chauhan - Georgetown UniversityCatherine Diefenbach - New York UniversityAllandria Straker-Edwards - Fox Chase Cancer CenterAndreas K. Klein - Tufts UniversityKristie A. Blum - Emory UniversityKirsten Marie Boughan - Case Western Reserve UniversityScott E. Smith - Loyola University Medical CenterBrad M. Haverkos - University of Colorado DenverVictor M. Orellana-Noia - University of VirginiaVaishalee P. Kenkre - University of Wisconsin–MadisonAdam Zayac - Brown UniversityJeremy Ramdial - University of MiamiSeth M. Maliske - University of IowaNarendranath Epperla - The Ohio State UniversityParameswaran Venugopal - Rush University Medical CenterTatyana A. Feldman - Rutgers, The State University of New JerseyStephen D. Smith - University of WashingtonAndrzej Stadnik - Oregon Health & Science UniversityKevin A. David - Rutgers, The State University of New JerseySeema Naik - Pennsylvania State UniversityIzidore S. Lossos - University of MiamiMatthew A. Lunning - University of Nebraska at OmahaPaolo Caimi - Case Western Reserve UniversityManali Kamdar - University of Colorado DenverNeil Palmisiano - Thomas Jefferson UniversityVeronika Bachanova - University of MinnesotaCraig A. Portell - University of VirginiaTycel Phillips - University of MichiganAdam J. Olszewski - Brown UniversityJuan Pablo Alderuccio - University of Miami
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.137(3), pp.374-386
- DOI
- 10.1182/blood.2020006926
- PMID
- 32663292
- PMCID
- PMC8765121
- NLM abbreviation
- Blood
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Publisher
- Amer Soc Hematology
- Number of pages
- 13
- Grant note
- P30 CA086862 / NCI NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI)
- Language
- English
- Date published
- 01/21/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984362738402771
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