Tan Jing Yuan, Qiu Tian Yu, Chiang Jianbang, Tan Ya Hwee, Yang Valerie Shiwen, Chang Esther Wei Yin, Poon Eileen, Somasundaram Nagavalli, Farid Mohamad, Tao Miriam, Lim Soon Thye, Chan Jason Yongsheng
Singhealth Internal Medicine Residency, Singapore General Hospital, Singapore.
Division of Medical Oncology, National Cancer Centre Singapore, Singapore.
Leuk Lymphoma. 2023 Mar;64(3):586-596. doi: 10.1080/10428194.2022.2027402. Epub 2022 Feb 19.
We analyzed the prognostic factors for treatment outcomes amongst 34 patients with adult Burkitt lymphoma (BL) who received rituximab with standard first-line chemotherapy. Seven patients had human immunodeficiency virus (HIV)-associated BL. Overall, we observed a complete remission (CR) rate of 91.2%, and 10-year progression-free survival (PFS) and overall survival (OS) was 84.8 and 88.2%, respectively. In patients with concomitant HIV, the prognosis was not different with 10-year PFS of 100% and OS of 88.2%. The majority (71.4%) of HIV-associated BL patients received dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) and had excellent outcomes with 100% CR and no relapses. Central nervous system (CNS) disease, bone marrow involvement and elevated serum lactate dehydrogenase (LDH) levels more than 3 times upper limit of normal (ULN) were associated with poorer survival outcomes. Patients with refractory disease, whilst uncommon ( = 4), had dismal outcomes. Patients with adult BL, including HIV-related cases, harbor generally good prognosis in the modern era.
我们分析了34例接受利妥昔单抗联合标准一线化疗的成人伯基特淋巴瘤（BL）患者治疗结果的预后因素。7例患者患有人类免疫缺陷病毒（HIV）相关的BL。总体而言，我们观察到完全缓解（CR）率为91.2%，10年无进展生存期（PFS）和总生存期（OS）分别为84.8%和88.2%。在合并HIV的患者中，预后无差异，10年PFS为100%，OS为88.2%。大多数（71.4%）HIV相关BL患者接受了剂量调整的EPOCH-R（依托泊苷、泼尼松、长春新碱、环磷酰胺、阿霉素和利妥昔单抗），并取得了优异的结果，CR率为100%，无复发。中枢神经系统（CNS）疾病、骨髓受累和血清乳酸脱氢酶（LDH）水平高于正常上限（ULN）3倍以上与较差的生存结果相关。难治性疾病患者虽然少见（n = 4），但预后不佳。在现代，包括HIV相关病例在内的成人BL患者总体预后良好。
