Ross Savannah, Eisenman Kristen, Maloney Kelly W
Department of Pediatric Hematology/Oncology/BMT, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
J Pediatr Hematol Oncol. 2019 Aug;41(6):498-500. doi: 10.1097/MPH.0000000000001287.
Pediatric Burkitt lymphoma has historically been treated with intensive methotrexate-based chemotherapy, which improves patient survival while causing severe toxicities. Young patients typically have better outcomes with intensive therapies, while adults and immunocompromised patients have higher toxicities and worse outcomes. Newer treatment regimens, including etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, rituximab (EPOCH-R), show promise for these patients. However, few studies exist to demonstrate efficacy and improved toxicity profile with EPOCH-R. We present 2 cases: a 25-year-old male with Down syndrome and an 18-year-old male with Burkitt lymphoma and significant renal injury who were successfully treated with EPOCH-R with minimal toxicities.
小儿伯基特淋巴瘤历来采用以大剂量甲氨蝶呤为基础的强化化疗进行治疗，这种治疗方法在提高患者生存率的同时会引发严重毒性。年轻患者接受强化治疗通常预后较好，而成年患者和免疫功能低下患者的毒性更高，预后更差。包括依托泊苷、泼尼松、长春新碱、环磷酰胺、多柔比星、利妥昔单抗（EPOCH-R）在内的新型治疗方案对这些患者显示出了希望。然而，很少有研究能证明EPOCH-R的疗效和改善的毒性特征。我们报告2例病例：1例患有唐氏综合征的25岁男性和1例患有伯基特淋巴瘤且有严重肾损伤的18岁男性，他们接受EPOCH-R治疗后成功治愈，且毒性极小。
