Dose-adjusted EPOCH-R therapy is suitable for adults with Burkitt lymphoma

  • Roschewski M & al.
  • J Clin Oncol
  • 26.05.2020

  • von Pavankumar Kamat
  • Studien – kurz & knapp
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Takeaway

  • 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.

Study details

  • 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.

Key results

  • 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. 

Limitations

  • Included few patients with active CSF involvement.