Journal article
HIV-associated Burkitt lymphoma: outcomes from a US-UK collaborative analysis
Blood advances, Vol.5(14), pp.2852-2862
07/27/2021
DOI: 10.1182/bloodadvances.2021004458
PMCID: PMC8341354
PMID: 34283175
Abstract
Data addressing prognostication in patients with HIV related Burkitt lymphoma (HIV-BL) currently treated remain scarce. We present an international analysis of 249 (United States: 140; United Kingdom: 109) patients with HIV-BL treated from 2008 to 2019 aiming to identify prognostic factors and outcomes. With a median follow up of 4.5 years, the 3-year progression-free survival (PFS) and overall survival (OS) were 61% (95% confidence interval [CI] 55% to 67%) and 66% (95%CI 59% to 71%), respectively, with similar results in both countries. Patients with baseline central nervous system (CNS) involvement had shorter 3-year PFS (36%) compared to patients without CNS involvement (69%; P < .001) independent of frontline treatment. The incidence of CNS recurrence at 3 years across all treatments was 11% with a higher incidence observed after dose-adjusted infusional etoposide, doxorubicin, vincristine, prednisone, cyclophosphamide (DA-EPOCH) (subdistribution hazard ratio: 2.52; P = .03 vs other regimens) without difference by CD4 count 100/mm3. In multivariate models, factors independently associated with inferior PFS were Eastern Cooperative Oncology Group (ECOG) performance status 2-4 (hazard ratio [HR] 1.87; P = .007), baseline CNS involvement (HR 1.70; P = .023), lactate dehydrogenase >5 upper limit of normal (HR 2.09; P < .001); and >1 extranodal sites (HR 1.58; P = .043). The same variables were significant in multivariate models for OS. Adjusting for these prognostic factors, treatment with cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC) was associated with longer PFS (adjusted HR [aHR] 0.45; P = .005) and OS (aHR 0.44; P = .007). Remarkably, HIV features no longer influence prognosis in contemporaneously treated HIV-BL.
Details
- Title: Subtitle
- HIV-associated Burkitt lymphoma: outcomes from a US-UK collaborative analysis
- Creators
- Juan Pablo Alderuccio - University of MiamiAdam J Olszewski - Brown UniversityAndrew M Evens - Rutgers, The State University of New JerseyGraham P Collins - Churchill HospitalAlexey V Danilov - City Of Hope National Medical CenterMark Bower - Chelsea and Westminster HospitalDeepa Jagadeesh - Cleveland ClinicCatherine Zhu - University College HospitalAmy Sperling - Fred Hutch Cancer CenterSeo-Hyun Kim - Rush University Medical CenterRyan Vaca - Pennsylvania State UniversityCatherine Wei - Rutgers, The State University of New JerseySuchitra Sundaram - Roswell Park Cancer InstituteNishitha Reddy - Vanderbilt University Medical CenterAlessia Dalla Pria - Chelsea and Westminster HospitalChristopher D'Angelo - University of Wisconsin–MadisonUmar Farooq - University of IowaDavid A Bond - The Ohio State UniversityStephanie Berg - Loyola University Medical CenterMichael C Churnetski - Emory UniversityAmandeep Godara - Tufts Medical CenterNadia Khan - Fox Chase Cancer CenterYun Kyong Choi - New York UniversityShireen Kassam - University of CambridgeEmma Rabinovich - University of Illinois ChicagoFrank A Post - University of CambridgeGaurav Varma - NewYork–Presbyterian HospitalReem Karmali - Northwestern UniversityMadelyn 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 Klein - Tufts Medical CenterKristie A Blum - Emory UniversityKirsten Marie Boughan - University Hospitals of ClevelandAgrima Mian - Cleveland ClinicBradley M Haverkos - University of Colorado DenverVictor M Orellana-Noia - Emory UniversityVaishalee P Kenkre - University of Wisconsin–MadisonAdam Zayac - Brown UniversitySeth M Maliske - University of IowaNarendranath Epperla - The Ohio State UniversityPaolo Caimi - University Hospitals of ClevelandScott E Smith - Loyola University Medical CenterManali Kamdar - University of Colorado DenverParameswaran Venugopal - Rush University Medical CenterTatyana A Feldman - Hackensack University Medical CenterDaniel Rector - Hackensack University Medical CenterStephen D Smith - Fred Hutch Cancer CenterAndrzej Stadnik - Oregon Health & Science UniversityCraig A Portell - University of VirginiaYong Lin - Rutgers, The State University of New JerseySeema Naik - Pennsylvania State UniversitySilvia Montoto - St Bartholomew's and The Royal London NHS Trust, London, United KingdomIzidore S Lossos - University of MiamiKate Cwynarski - University College Hospital
- Resource Type
- Journal article
- Publication Details
- Blood advances, Vol.5(14), pp.2852-2862
- DOI
- 10.1182/bloodadvances.2021004458
- PMID
- 34283175
- PMCID
- PMC8341354
- NLM abbreviation
- Blood Adv
- ISSN
- 2473-9529
- eISSN
- 2473-9537
- Grant note
- KL2 TR002534 / NCATS NIH HHS
- Language
- English
- Date published
- 07/27/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359666102771
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