TY - JOUR
T1 - Burkitt lymphoma in the modern era
T2 - Real-world outcomes and prognostication across 30 US cancer centers
AU - Evens, Andrew M.
AU - Danilov, Alexey
AU - Jagadeesh, Deepa
AU - Sperling, Amy
AU - Kim, Seo Hyun
AU - Vaca, Ryan
AU - Wei, Catherine
AU - Rector, Daniel
AU - Sundaram, Suchitra
AU - Reddy, Nishitha
AU - Lin, Yong
AU - Farooq, Umar
AU - D'Angelo, Christopher
AU - Bond, David A.
AU - Berg, Stephanie
AU - Churnetski, Michael C.
AU - Godara, Amandeep
AU - Khan, Nadia
AU - Choi, Yun Kyong
AU - Yazdy, Maryam
AU - Rabinovich, Emma
AU - Varma, Gaurav
AU - Karmali, Reem
AU - Mian, Agrima
AU - Savani, Malvi
AU - Burkart, Madelyn
AU - Martin, Peter
AU - Ren, Albert
AU - Chauhan, Ayushi
AU - Diefenbach, Catherine
AU - Straker-Edwards, Allandria
AU - Klein, Andreas K.
AU - Blum, Kristie A.
AU - Boughan, Kirsten Marie
AU - Smith, Scott E.
AU - Haverkos, Brad M.
AU - Orellana-Noia, Victor M.
AU - Kenkre, Vaishalee P.
AU - Zayac, Adam
AU - Ramdial, Jeremy
AU - Maliske, Seth M.
AU - Epperla, Narendranath
AU - Venugopal, Parameswaran
AU - Feldman, Tatyana A.
AU - Smith, Stephen D.
AU - Stadnik, Andrzej
AU - David, Kevin A.
AU - Naik, Seema
AU - Lossos, Izidore S.
AU - Lunning, Matthew A.
AU - Caimi, Paolo
AU - Kamdar, Manali
AU - Palmisiano, Neil
AU - Bachanova, Veronika
AU - Portell, Craig A.
AU - Phillips, Tycel
AU - Olszewski, Adam J.
AU - Alderuccio, Juan Pablo
N1 - Publisher Copyright:
© 2021 by The American Society of Hematology.
PY - 2021/1/21
Y1 - 2021/1/21
N2 - 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 included the following: median age, 47 years; HIV1, 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-monthmedian follow-up, 3-year PFS andOS 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).Outcomeswere 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] 5 1.70, P = .001; OS, HR 5 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR 5 1.60, P < .001; OS, HR 5 1.74, P = .003), lactate dehydrogenase > 33 normal (PFS, HR 5 1.83, P < .001; OS, HR 5 1.63, P = .009), and CNS involvement (PFS, HR5 1.52, P5 .017;OS, HR5 1.67, P5 .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.
AB - 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 included the following: median age, 47 years; HIV1, 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-monthmedian follow-up, 3-year PFS andOS 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).Outcomeswere 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] 5 1.70, P = .001; OS, HR 5 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR 5 1.60, P < .001; OS, HR 5 1.74, P = .003), lactate dehydrogenase > 33 normal (PFS, HR 5 1.83, P < .001; OS, HR 5 1.63, P = .009), and CNS involvement (PFS, HR5 1.52, P5 .017;OS, HR5 1.67, P5 .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.
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U2 - 10.1182/blood.2020006926
DO - 10.1182/blood.2020006926
M3 - Article
C2 - 32663292
AN - SCOPUS:85095881813
SN - 0006-4971
VL - 137
SP - 374
EP - 386
JO - Blood
JF - Blood
IS - 3
ER -
