Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol
Background: Burkitt lymphoma (BL) is treated with short, intensive, noncross resistant multidrug chemotherapy regimens. The management of this aggressive lymphoma is a challenge in our resource-limited setting, and the published data from India is scarce. Aim: This retrospective study aims to evalua...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2018-01-01
|
| Series: | South Asian Journal of Cancer |
| Subjects: | |
| Online Access: | http://journal.sajc.org/article.asp?issn=2278-330X;year=2018;volume=7;issue=3;spage=195;epage=199;aulast=Patekar |
| _version_ | 1818933594555416576 |
|---|---|
| author | Mukesh Patekar Ajay Gogia Akash Tiwari Lalit Kumar Atul Sharma Soumya Ranjan Mallick Mehar Chand Sharma Sanjay Thulkar Ritu Gupta |
| author_facet | Mukesh Patekar Ajay Gogia Akash Tiwari Lalit Kumar Atul Sharma Soumya Ranjan Mallick Mehar Chand Sharma Sanjay Thulkar Ritu Gupta |
| author_sort | Mukesh Patekar |
| collection | DOAJ |
| description | Background: Burkitt lymphoma (BL) is treated with short, intensive, noncross resistant multidrug chemotherapy regimens. The management of this aggressive lymphoma is a challenge in our resource-limited setting, and the published data from India is scarce. Aim: This retrospective study aims to evaluate the clinical features and treatment outcomes in adult patients with BL treated with uniform chemotherapy, cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine (CODOX-M/IVAC) protocol (± Rituximab). Materials and Methods: The hospital records between 2011 and 2017 were reviewed to identify adult patients (age ≥18 years) who were treated with CODOX-M/IVAC protocol (± Rituximab). The demographic and clinical details, treatment, outcomes, and toxicity were recorded from the patient's prospectively maintained case records. Results: Eighteen patients were included in this study. The median age was 38 years with male:female ratio 3.5:1. The majority of patients were high risk (14/18). All patients had extranodal site of involvement. The treatment completion rate was 83.3%. The overall response rate = 77.8% including complete response rate = 66.7%. Five patients (27%) had progressive disease on therapy. The estimated 2-year overall survival and event-free survival were 73% and 68.4%, respectively. The most common toxicity was myelosuppression (grade v3/4 neutropenia = 88.8%, grade 3/4 thrombocytopenia = 77.7%, and grade 3/4 anemia = 66.6%), febrile neutropenia was seen in 66.6% cases. Most common nonhematological toxicity was mucositis (grd3/4 = 33.3%). No toxic death was seen. Conclusion: This one of the first retrospective analyses of treatment outcomes from India suggests that our patients are demographically and clinically similar to the western counterpart. The treatment completion rate is high despite significant toxicity. BL has a good outcome if treated adequately. |
| first_indexed | 2024-12-20T04:50:52Z |
| format | Article |
| id | doaj.art-48883a3832294ef09b1602659c081cd8 |
| institution | Directory Open Access Journal |
| issn | 2278-330X |
| language | English |
| last_indexed | 2024-12-20T04:50:52Z |
| publishDate | 2018-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | South Asian Journal of Cancer |
| spelling | doaj.art-48883a3832294ef09b1602659c081cd82022-12-21T19:52:51ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2018-01-017319519910.4103/sajc.sajc_230_17Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocolMukesh PatekarAjay GogiaAkash TiwariLalit KumarAtul SharmaSoumya Ranjan MallickMehar Chand SharmaSanjay ThulkarRitu GuptaBackground: Burkitt lymphoma (BL) is treated with short, intensive, noncross resistant multidrug chemotherapy regimens. The management of this aggressive lymphoma is a challenge in our resource-limited setting, and the published data from India is scarce. Aim: This retrospective study aims to evaluate the clinical features and treatment outcomes in adult patients with BL treated with uniform chemotherapy, cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, cytarabine (CODOX-M/IVAC) protocol (± Rituximab). Materials and Methods: The hospital records between 2011 and 2017 were reviewed to identify adult patients (age ≥18 years) who were treated with CODOX-M/IVAC protocol (± Rituximab). The demographic and clinical details, treatment, outcomes, and toxicity were recorded from the patient's prospectively maintained case records. Results: Eighteen patients were included in this study. The median age was 38 years with male:female ratio 3.5:1. The majority of patients were high risk (14/18). All patients had extranodal site of involvement. The treatment completion rate was 83.3%. The overall response rate = 77.8% including complete response rate = 66.7%. Five patients (27%) had progressive disease on therapy. The estimated 2-year overall survival and event-free survival were 73% and 68.4%, respectively. The most common toxicity was myelosuppression (grade v3/4 neutropenia = 88.8%, grade 3/4 thrombocytopenia = 77.7%, and grade 3/4 anemia = 66.6%), febrile neutropenia was seen in 66.6% cases. Most common nonhematological toxicity was mucositis (grd3/4 = 33.3%). No toxic death was seen. Conclusion: This one of the first retrospective analyses of treatment outcomes from India suggests that our patients are demographically and clinically similar to the western counterpart. The treatment completion rate is high despite significant toxicity. BL has a good outcome if treated adequately.http://journal.sajc.org/article.asp?issn=2278-330X;year=2018;volume=7;issue=3;spage=195;epage=199;aulast=PatekarBurkitt lymphomacyclophosphamidecytarabine/uniform protocol/treatmentdoxorubicinetoposideifosfamidemethotrexateoutcomevincristine |
| spellingShingle | Mukesh Patekar Ajay Gogia Akash Tiwari Lalit Kumar Atul Sharma Soumya Ranjan Mallick Mehar Chand Sharma Sanjay Thulkar Ritu Gupta Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol South Asian Journal of Cancer Burkitt lymphoma cyclophosphamide cytarabine/uniform protocol/treatment doxorubicin etoposide ifosfamide methotrexate outcome vincristine |
| title | Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol |
| title_full | Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol |
| title_fullStr | Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol |
| title_full_unstemmed | Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol |
| title_short | Adult Burkitt lymphoma: An institutional experience with a uniform chemotherapy protocol |
| title_sort | adult burkitt lymphoma an institutional experience with a uniform chemotherapy protocol |
| topic | Burkitt lymphoma cyclophosphamide cytarabine/uniform protocol/treatment doxorubicin etoposide ifosfamide methotrexate outcome vincristine |
| url | http://journal.sajc.org/article.asp?issn=2278-330X;year=2018;volume=7;issue=3;spage=195;epage=199;aulast=Patekar |
| work_keys_str_mv | AT mukeshpatekar adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT ajaygogia adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT akashtiwari adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT lalitkumar adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT atulsharma adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT soumyaranjanmallick adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT meharchandsharma adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT sanjaythulkar adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol AT ritugupta adultburkittlymphomaaninstitutionalexperiencewithauniformchemotherapyprotocol |