Meiting Chen1, Zhao Wang1, Xiaojie Fang1, Yuyi Yao1, Quanguang Ren1, Zegeng Chen1, Ying Tian1, Fei Pan1, Xiaoqian Li1, Zhiming Li1, Qingqing Cai1, He Huang1, Tongyu Lin1,2. 1. Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China. 2. Senior Ward/Phase I Clinical Trial Ward, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China.
Abstract
OBJECTIVE: To characterize modified R-CODOX-M/IVAC-based chemotherapy to lower the severe adverse events in Chinese adult patients with sporadic Burkitt lymphoma. METHODS: We enrolled a retrospective cohort including 123 adult patients with untreated sporadic Burkitt lymphoma from August 2008 to September 2019 at Sun Yat-sen University Cancer Center. We studied a dose-modified and long-course R-CODOX-M/IVAC regimen utilizing a low dose of 1.0 g/m2/cycle cyclophosphamide, 2 g/m2/cycle methotrexate, 4,500 mg/m2/cycle ifosfamide, and 4.0 g/m2/cycle cytarabine. Forty-nine patients with low risk disease underwent 4-6 cycles of dose-modified R-CODOX-M-based chemotherapy. Seventy-four patients with high risk disease underwent 6-8 cycles of dose-modified alternating R-CODOX-M/IVAC regimens. RESULTS: The objective remission was 87.0%. The event-free survival rate and overall survival at 3 years were 81.2% and 92.1%, respectively. Major grade 3-4 adverse events included leukopenia (91.9%), anemia (58.5%), thrombocytopenia (73.2%), and febrile neutropenia (48.8%). A total of 26.0% and 37.4% of patients received red blood cell and platelet transfusions, respectively. We observed 4 cases (3.3%) of septic shock after chemotherapy. Two treatment-related deaths occurred from severe infection. CONCLUSIONS: The modified R-CODOX-M/IVAC chemotherapy regimen was effective for sporadic Burkitt lymphoma in the Chinese population, with a lower toxicity than standard regimens.
OBJECTIVE: To characterize modified R-CODOX-M/IVAC-based chemotherapy to lower the severe adverse events in Chinese adult patients with sporadic Burkitt lymphoma. METHODS: We enrolled a retrospective cohort including 123 adult patients with untreated sporadic Burkitt lymphoma from August 2008 to September 2019 at Sun Yat-sen University Cancer Center. We studied a dose-modified and long-course R-CODOX-M/IVAC regimen utilizing a low dose of 1.0 g/m2/cycle cyclophosphamide, 2 g/m2/cycle methotrexate, 4,500 mg/m2/cycle ifosfamide, and 4.0 g/m2/cycle cytarabine. Forty-nine patients with low risk disease underwent 4-6 cycles of dose-modified R-CODOX-M-based chemotherapy. Seventy-four patients with high risk disease underwent 6-8 cycles of dose-modified alternating R-CODOX-M/IVAC regimens. RESULTS: The objective remission was 87.0%. The event-free survival rate and overall survival at 3 years were 81.2% and 92.1%, respectively. Major grade 3-4 adverse events included leukopenia (91.9%), anemia (58.5%), thrombocytopenia (73.2%), and febrile neutropenia (48.8%). A total of 26.0% and 37.4% of patients received red blood cell and platelet transfusions, respectively. We observed 4 cases (3.3%) of septic shock after chemotherapy. Two treatment-related deaths occurred from severe infection. CONCLUSIONS: The modified R-CODOX-M/IVAC chemotherapy regimen was effective for sporadic Burkitt lymphoma in the Chinese population, with a lower toxicity than standard regimens.
Authors: Bruce D Cheson; Richard I Fisher; Sally F Barrington; Franco Cavalli; Lawrence H Schwartz; Emanuele Zucca; T Andrew Lister Journal: J Clin Oncol Date: 2014-09-20 Impact factor: 44.544
Authors: Graham M Mead; Sharon L Barrans; Wendi Qian; Jan Walewski; John A Radford; Max Wolf; Simon M Clawson; Sally P Stenning; Claire L Yule; Andrew S Jack Journal: Blood Date: 2008-07-08 Impact factor: 22.113
Authors: G M Mead; M R Sydes; J Walewski; A Grigg; C S Hatton; N Pescosta; C Guarnaccia; M S Lewis; J McKendrick; S P Stenning; D Wright; P Norbert Journal: Ann Oncol Date: 2002-08 Impact factor: 32.976
Authors: Takondwa Zuze; Grace K Ellis; Edwards Kasonkanji; Bongani Kaimila; Richard Nyasosela; Ruth Nyirenda; Tamiwe Tomoka; Maurice Mulenga; Maria Chikasema; Blessings Tewete; Asekanadziwa Mtangwanika; Sarah Chiyoyola; Fred Chimzimu; Coxcilly Kampani; Wilberforce Mhango; Simon Nicholas; Cara Randall; Nathan D Montgomery; George Fedoriw; Katherine D Westmoreland; Matthew S Painschab; Satish Gopal Journal: Cancer Med Date: 2019-11-09 Impact factor: 4.452