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Leo I. Gordon, MD, FACP


Comparison of Two Different Chemotherapy Regimens for High-Risk Burkitt Lymphoma

By: Emily Rhode
Posted: Friday, July 15, 2022

According to the results of the multicenter, randomized HOVON/SAKK trial comparing chemotherapy regimens in patients with Burkitt lymphoma, treatment with dose-adjusted EPOCH-R or R-CODOX-M/R-IVAC produced similar complete metabolic remission and survival rates. However, treatment with R-CODOX-M/R-IVAC resulted in fewer infectious complications and transfusions, as well as fewer total hospitalization days. The findings of M.E.D. Chamuleau, MD, PhD, of the Vrije Universiteit Amsterdam, the Netherlands, and colleagues were presented at the European Hematology Association (EHA) 2022 Annual Meeting (Abstract LB2370).

The study included 84 adults with newly diagnosed sporadic and HIV-associated high-risk Burkitt lymphoma. In arm A, 43 patients were fully dosed in 92% of cycles with R-CODOX-M/R-IVAC (rituximab plus cyclophosphamide, doxorubicin, vincristine, methotrexate in addition to rituximab plus ifosfamide, etoposide, high-dose cytarabine). In arm B, the maximum dose level for dose-adjusted EPOCH-R (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) was 1 in 35%, 2 in 19%, 3 in 24%, and 4 in 22% of patients. The rate of treatment discontinuation in arm A was 21% and 10% in arm B. Excessive toxicity led to discontinuation of treatment in four patients in arm A and zero patients in arm B. Arm A patients received a median of two platelet transfusions and five red blood cell transfusions, whereas those in arm B received zero and one, respectively. Patient hospitalizations were 46 nights in arm A and 25 nights in arm B. Comparable 2-year overall survival rates of 75% in arm A and 76% in arm B were noted.

The trial was reportedly the first multicenter randomized trial comparing these two treatment regimens in patients newly diagnosed with Burkitt lymphoma. Although the trial was designed to demonstrate improved progression-free survival from 70% in arm A to 85% in arm B, the trial was discontinued early due to slow accrual rates and lack of participation from a cooperating group.

Disclosure: For full disclosures of the study authors, visit

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