Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425-6350, USA.
Blood. 2013 Jun 13;121(24):4861-6. doi: 10.1182/blood-2012-12-475558. Epub 2013 May 2.
It is unknown whether the high rates of cure reported for Burkitt lymphoma/leukemia (BL) patients treated with chemoimmunotherapy can be verified outside published series and clinical trials. We used the Surveillance Epidemiology and End Results (SEER) database to describe time trends in outcomes of BL in the United States. Cases were divided into 2 eras based on year of diagnosis, reflecting improvements in HIV management, BL treatment, and supportive care. There was a marked improvement in survival among BL cases diagnosed in the 2002-2008 era (n = 1922) relative to 1973-2001 (n = 1769) with 5-year relative survival estimates of 56% and 43%, respectively (P < .001). Five-year relative survival improved from 71% to 87% for ages 0 to 19 (n = 970), 35% to 60% for ages 20 to 39 (n = 897), 28% to 48% for ages 40 to 59 (n = 1047), and from 25% to 33% for ages ≥60 (n = 777). In multivariable analysis, the 2002-2008 era (HR = 0.76, P < .001) was associated with lower mortality. Conversely, older age, black race, and advanced stage were associated with higher mortality. More effective therapies are needed for older patients with BL, along with improved access to modern therapy for younger patients.
尚不清楚在已发表的系列研究和临床试验之外,能否证实接受化疗免疫治疗的伯基特淋巴瘤/白血病 (BL) 患者的高治愈率。我们利用监测、流行病学和最终结果 (SEER) 数据库来描述美国 BL 患者结局的时间趋势。病例根据诊断年份分为两个时代,反映了 HIV 管理、BL 治疗和支持性护理的改善。与 1973-2001 年(n = 1769)相比,2002-2008 年诊断的 BL 病例(n = 1922)的生存情况明显改善,5 年相对生存率估计值分别为 56%和 43%(P <.001)。年龄为 0 至 19 岁(n = 970)的患者 5 年相对生存率从 71%提高到 87%,年龄为 20 至 39 岁(n = 897)的患者从 35%提高到 60%,年龄为 40 至 59 岁(n = 1047)的患者从 28%提高到 48%,年龄为 60 岁及以上(n = 777)的患者从 25%提高到 33%。多变量分析显示,2002-2008 年时代(HR = 0.76,P <.001)与死亡率降低相关。相反,年龄较大、黑人种族和晚期阶段与死亡率升高相关。需要为老年 BL 患者开发更有效的疗法,并为年轻患者提供更好的现代疗法。