Research Paper
Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002
David A. Rizzieri,
Jeffrey L. Johnson,
John C. Byrd,
Gerard Lozanski,
Kristie A. Blum,
Bayard L. Powell,
Thomas C. Shea,
Sreenivasa Nattam,
Eva Hoke,
Bruce D. Cheson,
Richard A. Larson,
for the Alliance for Clinical Trials In Oncology (ACTION),
Corresponding Author
David A. Rizzieri
Department of Medicine, Duke University Medical Center, Durham, NC, USA
Correspondence: David A. Rizzieri,
Department of Medicine, Division of Oncology and Bone Marrow Transplantation, Box 3961, Duke University Medical Center, Durham, NC 27710, USA.
E-mail: [email protected]
Search for more papers by this authorJeffrey L. Johnson
Alliance Statistical and Data Center, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorJohn C. Byrd
Division of Hematology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorGerard Lozanski
Department of Pathology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorKristie A. Blum
Division of Hematology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorBayard L. Powell
Wake Forest University, Winston Salem, NC, USA
Search for more papers by this authorThomas C. Shea
University of North Carolina, Chapel Hill, NC, USA
Search for more papers by this authorSreenivasa Nattam
Fort Wayne Medical Oncology & Hematology, Fort Wayne, IN, USA
Search for more papers by this authorEva Hoke
Alliance Statistical and Data Center, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorBruce D. Cheson
Georgetown University Hospital, Washington, DC, USA
Search for more papers by this authorthe Alliance for Clinical Trials In Oncology (ACTION)
Search for more papers by this authorDavid A. Rizzieri,
Jeffrey L. Johnson,
John C. Byrd,
Gerard Lozanski,
Kristie A. Blum,
Bayard L. Powell,
Thomas C. Shea,
Sreenivasa Nattam,
Eva Hoke,
Bruce D. Cheson,
Richard A. Larson,
for the Alliance for Clinical Trials In Oncology (ACTION),
Corresponding Author
David A. Rizzieri
Department of Medicine, Duke University Medical Center, Durham, NC, USA
Correspondence: David A. Rizzieri,
Department of Medicine, Division of Oncology and Bone Marrow Transplantation, Box 3961, Duke University Medical Center, Durham, NC 27710, USA.
E-mail: [email protected]
Search for more papers by this authorJeffrey L. Johnson
Alliance Statistical and Data Center, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorJohn C. Byrd
Division of Hematology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorGerard Lozanski
Department of Pathology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorKristie A. Blum
Division of Hematology, The Ohio State University, Columbus, OH, USA
Search for more papers by this authorBayard L. Powell
Wake Forest University, Winston Salem, NC, USA
Search for more papers by this authorThomas C. Shea
University of North Carolina, Chapel Hill, NC, USA
Search for more papers by this authorSreenivasa Nattam
Fort Wayne Medical Oncology & Hematology, Fort Wayne, IN, USA
Search for more papers by this authorEva Hoke
Alliance Statistical and Data Center, Duke University Medical Center, Durham, NC, USA
Search for more papers by this authorBruce D. Cheson
Georgetown University Hospital, Washington, DC, USA
Search for more papers by this authorthe Alliance for Clinical Trials In Oncology (ACTION)
Search for more papers by this authorPrior Presentations: Selected as an Oral Presentation for ASH 2010.
Summary
To improve long-term outcomes for Burkitt leukaemia/lymphoma (BL) or aggressive lymphomas in adults, we assessed the benefit of adding rituximab and filgrastim support to a dose-dense modified chemotherapy regimen from the Cancer and Leukemia Group B (CALGB) 9251 trial. One hundred and five patients (aged 19–79 years) were enrolled; 27% were >60 years old; 47% had high or high-intermediate risk by International Prognostic Index (IPI) criteria. Common severe toxicities included stomatitis/upper gastrointestinal toxicity (69%), renal insufficiency (10%), neurological events (25%) and pulmonary events (18%). Seven died from treatment-related causes (one central nervous system bleed, four infections, two respiratory failure); five were >60 years old. Results in this adult population are encouraging as complete response (CR) was observed in 83% and 4-year event-free (EFS) and overall survivals (OS) were 74% and 78%, respectively. Results compare favourably to our prior chemotherapy alone study (CALGB 9251) but despite this, high-risk patients still had worse outcomes. In conclusion, short duration, intensive chemo-immunotherapy is feasible and should be considered in adults with BL as it results in high remission rates and durable remissions.
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