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Rituximab with chemotherapy in children and adolescents with central nervous system and/or bone marrow‐positive B urkitt lymphoma/leukaemia: a Children's Oncology Group Report
Author(s) -
Goldman Stanton,
Smith Lynette,
Galardy Paul,
Perkins Sherrie L.,
Frazer John Kimble,
Sanger Warren,
Anderson James R.,
Gross Thomas G.,
Weinstein Howard,
Harrison Lauren,
Shiramizu Bruce,
Barth Matthew,
Cairo Mitchell S.
Publication year - 2014
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13040
Subject(s) - chemoimmunotherapy , medicine , rituximab , chemotherapy , lymphoma , oncology , regimen , bone marrow , chemotherapy regimen , surgery
Summary Children and adolescents with B urkitt L ymphoma ( BL ) and combined central nervous system ( CNS ) and bone marrow involvement still have a poor prognosis with chemotherapy alone. We therefore investigated in children and adolescents with bone marrow (≥25% blasts) and/or CNS ‐positive B urkitt lymphoma the chemoimmunotherapy combination of rituximab (375 mg/m 2 ) and the standard chemotherapy arm of our previously reported F rench‐ A merican‐ B ritish ( FAB ) L ymphome M alins de B urkitt ( LMB ) 96 trial. Central pathological and cytogenetic characterization was also performed. There were 40 evaluable patients with Burkitt histology (25 with leukaemia and 15 with CNS disease ± leukaemia). The chemoimmunotherapy regimen was well tolerated. The incidence of grade III / IV mucositis during induction cycles with combined chemotherapy and rituximab was 31% and 26%, respectively. The 3‐year event‐free survival ( EFS )/overall survival ( OS ) was 90% (95% confidence interval [ CI ], 76–96%) in the entire cohort and 93% (95% CI , 61–99%) in patients with CNS disease. Based on the results of this trial, an international randomized study of FAB / LMB 96 chemotherapy ± rituximab for high‐risk patients is currently under investigation.