Burkitt lymphoma in the modern era: Real-world outcomes and prognostication across 30 US cancer centers

Andrew M. Evens, Alexey Danilov, Deepa Jagadeesh, Amy Sperling, Seo Hyun Kim, Ryan Vaca, Catherine Wei, Daniel Rector, Suchitra Sundaram, Nishitha Reddy, Yong Lin, Umar Farooq, Christopher D'Angelo, David A. Bond, Stephanie Berg, Michael C. Churnetski, Amandeep Godara, Nadia Khan, Yun Kyong Choi, Maryam YazdyEmma Rabinovich, Gaurav Varma, Reem Karmali, Agrima Mian, Malvi Savani, Madelyn Burkart, Peter Martin, Albert Ren, Ayushi Chauhan, Catherine Diefenbach, Allandria Straker-Edwards, Andreas K. Klein, Kristie A. Blum, Kirsten Marie Boughan, Scott E. Smith, Brad M. Haverkos, Victor M. Orellana-Noia, Vaishalee P. Kenkre, Adam Zayac, Jeremy Ramdial, Seth M. Maliske, Narendranath Epperla, Parameswaran Venugopal, Tatyana A. Feldman, Stephen D. Smith, Andrzej Stadnik, Kevin A. David, Seema Naik, Izidore S. Lossos, Matthew A. Lunning, Paolo Caimi, Manali Kamdar, Neil Palmisiano, Veronika Bachanova, Craig A. Portell, Tycel Phillips, Adam J. Olszewski, Juan Pablo Alderuccio

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

We examined adults with untreated Burkitt lymphoma (BL) from 2009 to 2018 across 30 US cancer centers. Factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Among 641 BL patients, baseline features included the following: median age, 47 years; HIV1, 22%; Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 to 4, 23%; >1 extranodal site, 43%; advanced stage, 78%; and central nervous system (CNS) involvement, 19%. Treatment-related mortality was 10%, with most common causes being sepsis, gastrointestinal bleed/perforation, and respiratory failure.With 45-monthmedian follow-up, 3-year PFS andOS rates were 64% and 70%, respectively, without differences by HIV status. Survival was better for patients who received rituximab vs not (3-year PFS, 67% vs 38%; OS, 72% vs 44%; P < .001) and without difference based on setting of administration (ie, inpatient vs outpatient).Outcomeswere also improved at an academic vs community cancer center (3-year PFS, 67% vs 46%, P = .006; OS, 72% vs 53%, P = .01). In multivariate models, age 40 years (PFS, hazard ratio [HR] 5 1.70, P = .001; OS, HR 5 2.09, P < .001), ECOG PS 2 to 4 (PFS, HR 5 1.60, P < .001; OS, HR 5 1.74, P = .003), lactate dehydrogenase > 33 normal (PFS, HR 5 1.83, P < .001; OS, HR 5 1.63, P = .009), and CNS involvement (PFS, HR5 1.52, P5 .017;OS, HR5 1.67, P5 .014) predicted inferior survival. Furthermore, survival varied based on number of factors present (0, 1, 2 to 4 factors) yielding 3-year PFS rates of 91%, 73%, and 50%, respectively; and 3-year OS rates of 95%, 77%, and 56%, respectively. Collectively, outcomes for adult BL in this real-world analysis appeared more modest compared with results of clinical trials and smaller series. In addition, clinical prognostic factors at diagnosis identified patients with divergent survival rates.

Original languageEnglish (US)
Pages (from-to)374-386
Number of pages13
JournalBlood
Volume137
Issue number3
DOIs
StatePublished - Jan 21 2021

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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