TY - JOUR
T1 - HIV-associated Burkitt lymphoma
T2 - Outcomes from a US-UK collaborative analysis
AU - Alderuccio, Juan Pablo
AU - Olszewski, Adam J.
AU - Evens, Andrew M.
AU - Collins, Graham P.
AU - Danilov, Alexey V.
AU - Bower, Mark
AU - Jagadeesh, Deepa
AU - Zhu, Catherine
AU - Sperling, Amy
AU - Kim, Seo Hyun
AU - Vaca, Ryan
AU - Wei, Catherine
AU - Sundaram, Suchitra
AU - Reddy, Nishitha
AU - Pria, Alessia Dalla
AU - D'Angelo, Christopher
AU - Farooq, Umar
AU - Bond, David A.
AU - Berg, Stephanie
AU - Churnetski, Michael C.
AU - Godara, Amandeep
AU - Khan, Nadia
AU - Choi, Yun Kyong
AU - Kassam, Shireen
AU - Yazdy, Maryam
AU - Rabinovich, Emma
AU - Post, Frank A.
AU - Varma, Gaurav
AU - Karmali, Reem
AU - Burkart, Madelyn
AU - Martin, Peter
AU - Ren, Albert
AU - Chauhan, Ayushi
AU - Diefenbach, Catherine
AU - Straker-Edwards, Allandria
AU - Klein, Andreas
AU - Blum, Kristie A.
AU - Boughan, Kirsten Marie
AU - Mian, Agrima
AU - Haverkos, Bradley M.
AU - Orellana-Noia, Victor M.
AU - Kenkre, Vaishalee P.
AU - Zayac, Adam
AU - Maliske, Seth M.
AU - Epperla, Narendranath
AU - Caimi, Paolo
AU - Smith, Scott E.
AU - Kamdar, Manali
AU - Venugopal, Parameswaran
AU - Feldman, Tatyana A.
AU - Rector, Daniel
AU - Smith, Stephen D.
AU - Stadnik, Andrzej
AU - Portell, Craig A.
AU - Lin, Yong
AU - Naik, Seema
AU - Montoto, Silvia
AU - Lossos, Izidore S.
AU - Cwynarski, Kate
N1 - Funding Information:
provided consultancy services to Gilead, Bristol Myers Squibb (BMS), Merck Sharp & Dohme (MSD), Takeda, BeiGene, Roche, Celleron, ADC Therapeutics, Roche, Novartis, Celgene, and Pfizer; and received research funding from Amgen. A.V.D. provided consultancy services to, and received research funding from, AstraZeneca, BMS, Bayer Oncology, and Verastem Oncology; received research funding from Takeda Oncology, Gilead Sciences, Aptose Biosciences, BMS, and SecuraBio; and provided consultancy services to Bayer Oncology, Genentech, TG Therapeutics, Nurix, Celgene, Rigel Pharmaceuticals, Karyopharm, Pharmacyclics, AbbVie, and Bei-gene. D.J. provided consultancy services to Seattle Genetics and Verastem; and received research funding from Debiopharm Group, MEI Pharma, and Regeneron. N.R. received research funding from Genentech, and provided consultancy services to AbbVie, BMS, Celgene, and Kite. U.F. received honoraria from Kite. D.A.B. received honoraria from Seattle Genetics. N.K. received research funding from Celgene, BMS, and Seattle Genetics; and provided consultancy services to Pharmacyclics. M.Y. provided consultancy services to Bayer, Octapharma, and AbbVie; and received research funding from Genentech. R.K. served on a speakers bureau for As-traZeneca, Beigene, and Kite/Gilead; provided consultant services to Kite/Gilead, BMS/Juno, Karyopharm, Janssen, and Morhphosys; and received research funding from Kite/Gilead, BMS/Juno, and Takeda. P.M. provided consultancy services to Incyte, Regeneron, Celgene, Bayer, Cellectar, BeiGene, Teneobio, Karyopharm, Jans-sen, Sandoz, I-MAB, Morphosys, and Kite. C. Diefenbach received research funding from Trillium, Millennium/Takeda, LAM Therapeutics, Incyte, and Denovo; and provided consultancy services to Seattle Genetics, Merck, MEI, Genentech, and BMS. A.K. provided consultancy services to Takeda. B.M.H. provided consultancy services to Viracta Therapeutics. N.E. provided consultancy services to Verastem Oncology and Pharmacyclics. P.C. provided consultancy services to Amgen, Bayer, Kite Pharma, ADC Therapeutics, Cel-gene, and Verastem. M.K. received research funding from Roche. T.A.F. received research funding from Eisai, Pfizer, Portola, Trillium, Cell Medica, Amgen, Viracta, Rhizen, and Corvus; and provided consultancy services to Kyowa Kirin, Janssen, AstraZeneca, Pharma-cyclics, Bayer, BMS, Kite, Celgene, Takeda, and Seattle Genetics. S.E.S. provided consultancy services to AstraZeneca, Millennium/ Takeda, and BeiGene; and received research funding from Seattle Genetics, Ayala, Bayer, Acerta Pharma BV, BMS, Portola, Pharma-cyclics, Merck, Incyte, Ignyta, Genentech, and De Novo Biopharma. C.A.P. provided consultancy services to Amgen, Pharmacyclics, Janssen, Bayer, BeiGene, and Kite; and received research funding from AbbVie, TG Therapeutics, Xencor, Acerta/AstraZeneca, Infinity, and Roche/Genentech. S.N. provided consultancy services to Cel-gene and Sanofi. S.M. served on a DMC for Bayer; was a speaker for Janssen; and received a travel grant from Gilead. I.S.L. provided consultancy services to Janssen Biotech, Verastem, Seattle Genetics, and Janssen. K.C. provided consultancy services to Takeda, Celgene, Janssen, Roche, Gilead, Atara, and Kite. The remaining authors declare no competing financial interests.
Funding Information:
Conflict-of-interest disclosure: J.P.A. received honoraria from On-cinfo and OncLive; provided consultancy services to ADC Therapeutics, and has immediate family members who received honoraria from Puma Biotechnology, Agios, Inovio Pharmaceuticals, and Foundation Medicine. A.J.O. received research funding from Spectrum Pharmaceuticals, TG Therapeutics, Adaptive Biotechnologies, and Genentech, Inc. A.M.E. provided consultancy services to, and received honoraria from, Seattle Genetics, Verastem, Affimed, and Bayer; received honoraria from Research to Practice; received honoraria from Pharmacyclics for Data Safety Monitoring Committe services; and received research funding from Takeda and Merck. G.P.C.
Publisher Copyright:
© 2021 American Society of Hematology. All rights reserved.
PY - 2021/7/27
Y1 - 2021/7/27
N2 - Data addressing prognostication in patients with HIV related Burkitt lymphoma (HIV-BL) currently treated remain scarce. We present an international analysis of 249 (United States: 140; United Kingdom: 109) patients with HIV-BL treated from 2008 to 2019 aiming to identify prognostic factors and outcomes. With a median follow up of 4.5 years, the 3- year progression-free survival (PFS) and overall survival (OS) were 61% (95% confidence interval [CI] 55% to 67%) and 66% (95%CI 59% to 71%), respectively, with similar results in both countries. Patients with baseline central nervous system (CNS) involvement had shorter 3-year PFS (36%) compared to patients without CNS involvement (69%; P < .001) independent of frontline treatment. The incidence of CNS recurrence at 3 years across all treatments was 11% with a higher incidence observed after dose-adjusted infusional etoposide, doxorubicin, vincristine, prednisone, cyclophosphamide (DA-EPOCH) (subdistribution hazard ratio: 2.52; P = .03 vs other regimens) without difference by CD4 count 100/mm3. In multivariate models, factors independently associated with inferior PFS were Eastern Cooperative Oncology Group (ECOG) performance status 2-4 (hazard ratio [HR] 1.87; P = .007), baseline CNS involvement (HR 1.70; P = .023), lactate dehydrogenase >5 upper limit of normal (HR 2.09; P < .001); and >1 extranodal sites (HR 1.58; P = .043). The same variables were significant in multivariate models for OS. Adjusting for these prognostic factors, treatment with cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC) was associated with longer PFS (adjusted HR [aHR] 0.45; P = .005) and OS (aHR 0.44; P = .007). Remarkably, HIV features no longer influence prognosis in contemporaneously treated HIV-BL.
AB - Data addressing prognostication in patients with HIV related Burkitt lymphoma (HIV-BL) currently treated remain scarce. We present an international analysis of 249 (United States: 140; United Kingdom: 109) patients with HIV-BL treated from 2008 to 2019 aiming to identify prognostic factors and outcomes. With a median follow up of 4.5 years, the 3- year progression-free survival (PFS) and overall survival (OS) were 61% (95% confidence interval [CI] 55% to 67%) and 66% (95%CI 59% to 71%), respectively, with similar results in both countries. Patients with baseline central nervous system (CNS) involvement had shorter 3-year PFS (36%) compared to patients without CNS involvement (69%; P < .001) independent of frontline treatment. The incidence of CNS recurrence at 3 years across all treatments was 11% with a higher incidence observed after dose-adjusted infusional etoposide, doxorubicin, vincristine, prednisone, cyclophosphamide (DA-EPOCH) (subdistribution hazard ratio: 2.52; P = .03 vs other regimens) without difference by CD4 count 100/mm3. In multivariate models, factors independently associated with inferior PFS were Eastern Cooperative Oncology Group (ECOG) performance status 2-4 (hazard ratio [HR] 1.87; P = .007), baseline CNS involvement (HR 1.70; P = .023), lactate dehydrogenase >5 upper limit of normal (HR 2.09; P < .001); and >1 extranodal sites (HR 1.58; P = .043). The same variables were significant in multivariate models for OS. Adjusting for these prognostic factors, treatment with cyclophosphamide, vincristine, doxorubicin, and high-dose methotrexate, ifosfamide, etoposide, and high-dose cytarabine (CODOX-M/IVAC) was associated with longer PFS (adjusted HR [aHR] 0.45; P = .005) and OS (aHR 0.44; P = .007). Remarkably, HIV features no longer influence prognosis in contemporaneously treated HIV-BL.
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U2 - 10.1182/bloodadvances.2021004458
DO - 10.1182/bloodadvances.2021004458
M3 - Article
C2 - 34283175
AN - SCOPUS:85111191996
SN - 2473-9529
VL - 5
SP - 2852
EP - 2862
JO - Blood advances
JF - Blood advances
IS - 14
ER -