Good outcome of AIDS-related Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) with abbreviated cycles of EPOCH-rituximab
| العنوان: | Good outcome of AIDS-related Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) with abbreviated cycles of EPOCH-rituximab |
|---|---|
| المؤلفون: | AS Wayne, K Dunleavy, Robert Yarchoan, J Janik, Stefania Pittaluga, WH Wilson, Nicole Grant, Richard F. Little, J Carrasquillo, Seth M. Steinberg, ES Jaffe |
| المصدر: | Infectious Agents and Cancer, Vol 4, Iss Suppl 2, p O9 (2009) Infectious Agents and Cancer |
| بيانات النشر: | Springer Science and Business Media LLC, 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Vincristine, Epidemiology, medicine.medical_treatment, CHOP, lcsh:RC254-282, Gastroenterology, lcsh:Infectious and parasitic diseases, Internal medicine, medicine, lcsh:RC109-216, EPOCH (chemotherapy), Chemotherapy, business.industry, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Surgery, Infectious Diseases, Oncology, Absolute neutrophil count, Oral Presentation, Rituximab, AIDS-Related Burkitt Lymphoma, business, Diffuse large B-cell lymphoma, medicine.drug |
| الوصف: | The addition of rituximab to CHOP chemotherapy may augment tumor response but in patients with low CD4 counts, one study suggested that this benefit may be offset by increased infectious deaths (Kaplan. Blood 2005; 106:1538). We hypothesized that the addition of rituximab to EPOCH chemotherapy could improve tumor kill, allowing fewer cycles of treatment and therefore reducing toxicity. Patients received EPOCH-R (in mg/m2/d – etoposide 50, vincristine 0.4 and doxorubicin 10 all CIV d 1–5; cyclophosphamide 750 mg IV d 5; prednisone 60 po days 1–5 and rituximab 375 IV d 1,5 and G-CSF sc d 6–15) every 21 days. Prophlactic IT methotrexate was administered and HAART was suspended during therapy. Cyclophosphamide was adjusted based on absolute neutrophil count (ANC) nadir. Response was assessed by CT and FDG-PET scan and patients received one cycle beyond CR for a minimum of three cycles. Characteristics of 40 enrolled patients are: median (range) age 42 (9–60) years; IPI 3 (0–4); ECOG PS 1 (1–4), CD4 count 222 (0–835) cells/mm3; HIV viral load 34,766 (0–6,080000) RNA copies/mL; male sex 35 (88%); LDH > N 27 (68%); stage IV 27 (68%) and histology DLBCL 32 (80%) and BL 8 (20%). Of 38 evaluable patients (2NE), median (range) number of cycles given is three (3–5) with CR/CRu in 35 (92%) and PR in one (3%) patients. All eight patients with Burkitt lymphoma are in continuous remission. At four years median potential follow-up, PFS and OS are 86 percent and 70 percent. For patients with CD4 > and 100/mm3 have an extremely favorable outcome with and survival following EPOCH-R. The addition of rituximab did not appear to contribute to infection related complications or deaths. EPOCH-R showed excellent efficacy in eight patients with BL with an OS and PFS of 100 percent. PET scanning has a high negative but low positive predictive value for subsequent relapse. Accrual continues. |
| تدمد: | 1750-9378 |
| DOI: | 10.1186/1750-9378-4-s2-o9 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::306a69c91167dedb441b151fb128d8f0 https://doi.org/10.1186/1750-9378-4-s2-o9 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....306a69c91167dedb441b151fb128d8f0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17509378 |
|---|---|
| DOI: | 10.1186/1750-9378-4-s2-o9 |