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Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma†
Final Results of Cancer and Leukemia Group B Study 9251
Article first published online: 4 MAR 2004
Copyright © 2004 American Cancer Society
Volume 100, Issue 7, pages 1438–1448, 1 April 2004
How to Cite
Rizzieri, D. A., Johnson, J. L., Niedzwiecki, D., Lee, E. J., Vardiman, J. W., Powell, B. L., Barcos, M., Bloomfield, C. D., Schiffer, C. A., Peterson, B. A., Canellos, G. P. and Larson, R. A. (2004), Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma. Cancer, 100: 1438–1448. doi: 10.1002/cncr.20143
The views expressed herein do not necessarily reflect the views of the National Cancer Institute or the U.S. Government.
- Issue published online: 18 MAR 2004
- Article first published online: 4 MAR 2004
- Manuscript Revised: 13 JAN 2004
- Manuscript Accepted: 13 JAN 2004
- Manuscript Received: 22 SEP 2003
- National Cancer Institute (NCI). Grant Numbers: CA31946, CA77658, CA10-1140
- Cancer and Leukemia Group B (CALGB; Richard L. Schilsky, M.D., Chairman)
- Burkitt leukemia;
- Burkitt lymphoma;
- central nervous system prophylaxis non-Hodgkin lymphoma;
- small noncleaved cell lymphoma
The objective of the current study was to evaluate the efficacy of intensive chemotherapy with and without cranial radiation for central nervous system (CNS) prophylaxis in adults with Burkitt leukemia or lymphoma.
Patients received 18 weeks of therapy. Prophylactic cranial radiation (2400 centigrays) and 12 doses of triple intrathecal chemotherapy were administered to the first cohort of patients. A subsequent cohort received the same therapy, with the exceptions that intrathecal therapy was reduced to six doses and radiotherapy was administered only to high-risk individuals.
The median follow-up durations were 6.8 years in Cohort 1 and 4.1 years in Cohort 2. Three occurrences of transverse myelitis, 2 severe neuropathies, 3 cases of aphasia, and 1 case of blindness were documented in the first cohort of 52 patients (Cohort 1). In the subsequent cohort of 40 patients (Cohort 2), none of these occurrences were observed, and patients experienced less neurologic toxicity overall (61% vs. 26%; P = 0.001). Responses were similar, and the 3-year event-free survival rate was 0.52 (95% confidence interval, 0.38–0.65) for Cohort 1 and 0.45 (0.29–0.60) for Cohort 2.
Intensive, short-duration chemotherapy with less intensive CNS prophylaxis led to control at this sanctuary site with little neurotoxicity and may be curative for adults with Burkitt leukemia or lymphoma. Cancer 2004;100:1438–48. ©2004 by the American Cancer Society.