A prospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial).
dc.contributor.author | Mead, Graham M | |
dc.contributor.author | Barrans, Sharon L | |
dc.contributor.author | Qian, Wendi | |
dc.contributor.author | Walewski, Jan | |
dc.contributor.author | Radford, John A | |
dc.contributor.author | Wolf, Max | |
dc.contributor.author | Clawson, Simon | |
dc.contributor.author | Stenning, Sally P | |
dc.contributor.author | Yule, Claire L | |
dc.contributor.author | Jack, Andrew S | |
dc.date.accessioned | 2009-03-16T16:37:06Z | |
dc.date.available | 2009-03-16T16:37:06Z | |
dc.date.issued | 2008-09-15 | |
dc.identifier.citation | A prospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial). 2008, 112 (6):2248-60 Blood | en |
dc.identifier.issn | 1528-0020 | |
dc.identifier.pmid | 18612102 | |
dc.identifier.doi | 10.1182/blood-2008-03-145128 | |
dc.identifier.uri | http://hdl.handle.net/10541/55797 | |
dc.description.abstract | This prospective study aimed to develop reproducible diagnostic criteria for sporadic Burkitt lymphoma (BL), applicable to routine practice, and to evaluate the efficacy of dose-modified (dm) CODOX-M/IVAC in patients diagnosed using these criteria. The study was open to patients with an aggressive B-cell lymphoma with an MKI67 fraction approaching 100%. Immunophenotype and fluorescent in situ hybridization (FISH) were used to separate BL from other aggressive B-cell lymphomas. BL was characterized by the presence of a cMYC rearrangement as a sole cytogenetic abnormality occurring in patients with a germinal center phenotype with absence of BCL-2 expression and abnormal TP53 expression. A total of 128 patients were eligible for the study, of whom 58 were considered to have BL and 70 to have diffuse large B-cell lymphoma (DLBCL). There were 110 clinically fit patients who received dmCODOX-M (methotrexate, dose 3 g/m(2)) with or without IVAC according to risk group. The 2-year progression-free survival was 64% (95% confidence interval [CI] 51%-77%) for BL, 55% (95% CI 42%-66%) for DLBCL, 85% (95% CI 73%-97%) for low risk, and 49% (95% CI 38%-60%) for high-risk patients. The observed differences in outcome and other clinical features validate the proposed diagnostic criteria. Compared with the previous trial LY06 with full-dose methotrexate (6.7 g/m(2)), there was a reduction in toxicity with comparable outcomes. This study was registered at www.clinicaltrials.gov as NCT00040690. | |
dc.language.iso | en | en |
dc.subject | Burkitt Lymphoma | en |
dc.subject | Clinical Trial | en |
dc.subject | CODOX-M/IVAC | en |
dc.subject | Clinicopathologic Study | en |
dc.subject | MRC/NCRI LY10 trial | en |
dc.subject.mesh | Aged | |
dc.subject.mesh | Antineoplastic Combined Chemotherapy Protocols | |
dc.subject.mesh | Burkitt Lymphoma | |
dc.subject.mesh | Cyclophosphamide | |
dc.subject.mesh | Cytarabine | |
dc.subject.mesh | Cytogenetic Analysis | |
dc.subject.mesh | Disease-Free Survival | |
dc.subject.mesh | Doxorubicin | |
dc.subject.mesh | Etoposide | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Ifosfamide | |
dc.subject.mesh | Immunophenotyping | |
dc.subject.mesh | Methotrexate | |
dc.subject.mesh | Middle Aged | |
dc.subject.mesh | Treatment Outcome | |
dc.subject.mesh | Vincristine | |
dc.title | A prospective clinicopathologic study of dose-modified CODOX-M/IVAC in patients with sporadic Burkitt lymphoma defined using cytogenetic and immunophenotypic criteria (MRC/NCRI LY10 trial). | en |
dc.type | Article | en |
dc.contributor.department | Southampton University Hospitals Trust, Southampton, United Kingdom. | en |
dc.identifier.journal | Blood | en |
html.description.abstract | This prospective study aimed to develop reproducible diagnostic criteria for sporadic Burkitt lymphoma (BL), applicable to routine practice, and to evaluate the efficacy of dose-modified (dm) CODOX-M/IVAC in patients diagnosed using these criteria. The study was open to patients with an aggressive B-cell lymphoma with an MKI67 fraction approaching 100%. Immunophenotype and fluorescent in situ hybridization (FISH) were used to separate BL from other aggressive B-cell lymphomas. BL was characterized by the presence of a cMYC rearrangement as a sole cytogenetic abnormality occurring in patients with a germinal center phenotype with absence of BCL-2 expression and abnormal TP53 expression. A total of 128 patients were eligible for the study, of whom 58 were considered to have BL and 70 to have diffuse large B-cell lymphoma (DLBCL). There were 110 clinically fit patients who received dmCODOX-M (methotrexate, dose 3 g/m(2)) with or without IVAC according to risk group. The 2-year progression-free survival was 64% (95% confidence interval [CI] 51%-77%) for BL, 55% (95% CI 42%-66%) for DLBCL, 85% (95% CI 73%-97%) for low risk, and 49% (95% CI 38%-60%) for high-risk patients. The observed differences in outcome and other clinical features validate the proposed diagnostic criteria. Compared with the previous trial LY06 with full-dose methotrexate (6.7 g/m(2)), there was a reduction in toxicity with comparable outcomes. This study was registered at www.clinicaltrials.gov as NCT00040690. |
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Medical Oncology
Medical Oncology