- In adults with Burkitt lymphoma, dose-adjusted etoposide, doxorubicin, and vincristine with prednisone, cyclophosphamide, and rituximab (EPOCH-R) chemotherapy may offer similar outcomes to high-dose therapy but with lower toxicity.
Why this matters
- Highly dose-intensive chemotherapy regimens are effective in children and young adults with Burkitt lymphoma.
- Older patients, however, particularly those with comorbidities, are likely to experience severe adverse effects and late sequelae.
- Patients with untreated Burkitt lymphoma (n=113) were assigned to low- and high-risk categories.
- High-risk patients received 6 cycles and low-risk patients received 3 cycles of dose-adjusted EPOCH-R.
- Central nervous system prophylaxis/intrathecal methotrexate was provided to all patients based on positron emission tomography findings.
- Funding: National Cancer Institute.
- At follow-up, the overall 4-year event-free survival (EFS) was 84.5%, and OS was 87.0%.
- All low-risk patients were in remission.
- In high-risk patients, EFS was 82.1%, and OS was 84.9%.
- Treatment was equally effective across age groups, irrespective of HIV status and International Prognostic Index risk group.
- 55% of patients with cerebrospinal fluid (CSF) involvement at presentation had disease progression or died.
- Grade 3/4 thrombocytopenia occurred during 17% of cycles and febrile neutropenia in 16%.
- 4% of patients died because of treatment-related toxicity.
- Included few patients with active CSF involvement.