TREATMENT'OF'ADULT'BURKITT'LYMPHOMA'WITH'CALGB'1002'PROTOCOL:'
POSTER'28'
A'SINGLE'CENTER'EXPERIENCE''
'
Mohammad!Ma'koseh,!Khalid!Halahleh,!Baha'!Sharaf,!Alaa!Abufara!and!Rula!Amarin!
!
King!Hussein!Cancer!Center,!Amman,!Jordan!
!
Background:!
Burkitt!lymphoma!is!a!highly!aggressive!and!rare!nonJhodgkin!lymphoma!(NHL).!Treatment!
with!multidrug!non!cross!resistant!pediatric!inspired!chemotherapy!protocols!usually!results!
in!high!cure!rates!with!significant!toxicity.!Here!we!report!our!experience!with!CALGB!1002!
protocol!in!treatment!of!adults!with!Burkitt!lymphoma.!
Patients'and'methods:!
Files! and! medical! records! of! adult! patients! diagnosed! with! Burkitt! lymphoma! and! treated!
with! CALGB! 1002! protocol! in! King! Hussein! Cancer! Center! were! reviewed.! Baseline!
demographic,! clinical! and! laboratory! features! were! collected.! Timing! of! administration! of!
chemotherapy,! hematological! and! nonJhematological! toxicities,! response! rate,! treatment!
related! mortality! and! relapse! were! analyzed.! Event! free! survival! and! overall! survival! were!
blotted!using!Kaplan!Meir!curves.!
Results:!
19!patients!were!included,!12!(63%)!were!males.!Median!age!was!33!years!(range,!19J65).!11!
patients!(58%)!were!having!advanced!stage!disease,!14!(73.6%)!had!extranodal!involvement.!
CNS! involvement! was! fond! in! 2! patients! (10.5%)! and! the! same! applies! to! bone! marrow!
involvement.! Total! of! 106! cycles! were! given,! median! time! between! them! was! 23! days!
(range,!19J84!days).!16!patients!(84%)!achieved!complete!response.!After!median!followJup!
of! 36! months,! 3Jyears! event! free! survival! and! overall! survival! were! 78.95%! (figure! 1).! 2!
patients! (10.5%)! died! because! of! chemotherapy! related! toxicity! and! another! 2! patients!
(10.5%)! died! because! of! progressive! disease.! Among! the! whole! group,! grade! IIIJ! IV!
neutropenia!and!thrombocytopenia!were!found!in!59%!of!chemotherapy!cycles!while!febrile!
neutropenia!occurred!after!52.9%!despite!filgrastim!and!antibiotic!prophylaxis.!Grade!IIIJIV!
mucositis! complicated! 48.2%! of! cycles.! When! stratifying! patients! according! to! the! age! on!
diagnosis!(!<!45!years!vs.!≥45!years),!garde!IIIJIV!neutropenia!,!thrombocytopenia!and!febrile!
neutropenia! were! more! common! in! the! older! age! group! (! 52.1%! vs.! 77.1%,! ,! 45.1! %! vs.!
68.6%,!46.4!vs.!68.7%)!as!well!as!grade!IIIJIV!mucositis!(40.8%!vs!62.8%)!.!Hepatotoxicity!and!
nephrotoxicity!were!reported!in!47.2%!and!15.1%!of!cycles!respectively.!
Conclusion:!
Although!CALGB!1002!protocol!can!be!timely!administered!to!most!adult!Burkitt!lymphoma!
patients,!it!is!associated!with!significant!toxicity.!Risk!adapted!approach!and!consideration!of!
other! less! toxic! chemotherapeutic! regimens! should! be! considered! especially! in! older! age!