Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea
BackgroundBurkitt lymphoma (BL), a rare, aggressive MYC-driven B-cell non-Hodgkin lymphoma (NHL), has endemic, sporadic, and immunodeficiency-associated variants. In Asia, BL accounts for 1–2% of lymphomas, with limited data available on adult outcomes. Although potentially curable, BL is associated...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1614506/full |
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| author | Gi-June Min Ka Young Kim Tong Yoon Kim Young-Woo Jeon Byung-Su Kim Seung-Ah Yahng Ki-Seong Eom Seok-Goo Cho |
| author_facet | Gi-June Min Ka Young Kim Tong Yoon Kim Young-Woo Jeon Byung-Su Kim Seung-Ah Yahng Ki-Seong Eom Seok-Goo Cho |
| author_sort | Gi-June Min |
| collection | DOAJ |
| description | BackgroundBurkitt lymphoma (BL), a rare, aggressive MYC-driven B-cell non-Hodgkin lymphoma (NHL), has endemic, sporadic, and immunodeficiency-associated variants. In Asia, BL accounts for 1–2% of lymphomas, with limited data available on adult outcomes. Although potentially curable, BL is associated with poor outcomes with low-intensity chemotherapy owing to rapid proliferation and chemoresistance. Therefore, high-intensity regimens including R-hyperCVAD/MC (Course A of rituximab, cyclophosphamide, doxorubicin, vincristine, and dexamethasone; Course B of rituximab, methotrexate, and cytarabine) have been commonly used; however, no optimal strategy has been established.MethodsThis retrospective study included 69 adult patients with BL (age >15 years) diagnosed between 2009 and 2023 using the WHO criteria. Most of the patients were administered R-hyperCVAD/MC, while rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was administered to older patients or those with poor-performance-status to mitigate toxicity.ResultsThe median age of the patients was 55 years; 39.1% of the patients had Eastern Cooperative Oncology Group Performance Status (ECOG-PS) of 2–4, 62.3% had >1 extranodal site, 71.0% had stage IV, and 13.0% had central nervous system involvement. Furthermore, 13 (18.8%) patients were reclassified as BL after immunoglobulin heavy‐chain (IGH)/MYC detection. Overall, 52 patients were administered R-hyperCVAD/MC exclusively, 5 switched from R-CHOP, and 4 patients were primarily treated with R-CHOP owing to intolerance. At a median follow-up of 66.9 months, 5-year overall survival (OS) and event-free survival (EFS) were 69.5 and 65.2%, respectively and higher early mortality was observed in older patients (median survival: 3.9 months). Poor OS was associated with B-symptoms (hazard ratio [HR] 3.89, p = 0.003) and age ≥ 60 years (HR 2.54, p = 0.034); while poor EFS was associated with ECOG-PS 2–4 (HR 2.72, p = 0.024).ConclusionsOur study revealed that R-hyperCVAD/MC was effective but associated with high early mortality in older patients. Risk-adapted regimens and prognostic factors including age, B-symptoms, and ECOG-PS are crucial for optimizing treatment. |
| format | Article |
| id | doaj-art-9f5b8055fd594eb2aaea15f32c9c2cd7 |
| institution | DOAJ |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-9f5b8055fd594eb2aaea15f32c9c2cd72025-08-20T03:17:24ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.16145061614506Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in KoreaGi-June Min0Ka Young Kim1Tong Yoon Kim2Young-Woo Jeon3Byung-Su Kim4Seung-Ah Yahng5Ki-Seong Eom6Seok-Goo Cho7Department of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of KoreaDepartment of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaDepartment of Hematology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaBackgroundBurkitt lymphoma (BL), a rare, aggressive MYC-driven B-cell non-Hodgkin lymphoma (NHL), has endemic, sporadic, and immunodeficiency-associated variants. In Asia, BL accounts for 1–2% of lymphomas, with limited data available on adult outcomes. Although potentially curable, BL is associated with poor outcomes with low-intensity chemotherapy owing to rapid proliferation and chemoresistance. Therefore, high-intensity regimens including R-hyperCVAD/MC (Course A of rituximab, cyclophosphamide, doxorubicin, vincristine, and dexamethasone; Course B of rituximab, methotrexate, and cytarabine) have been commonly used; however, no optimal strategy has been established.MethodsThis retrospective study included 69 adult patients with BL (age >15 years) diagnosed between 2009 and 2023 using the WHO criteria. Most of the patients were administered R-hyperCVAD/MC, while rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was administered to older patients or those with poor-performance-status to mitigate toxicity.ResultsThe median age of the patients was 55 years; 39.1% of the patients had Eastern Cooperative Oncology Group Performance Status (ECOG-PS) of 2–4, 62.3% had >1 extranodal site, 71.0% had stage IV, and 13.0% had central nervous system involvement. Furthermore, 13 (18.8%) patients were reclassified as BL after immunoglobulin heavy‐chain (IGH)/MYC detection. Overall, 52 patients were administered R-hyperCVAD/MC exclusively, 5 switched from R-CHOP, and 4 patients were primarily treated with R-CHOP owing to intolerance. At a median follow-up of 66.9 months, 5-year overall survival (OS) and event-free survival (EFS) were 69.5 and 65.2%, respectively and higher early mortality was observed in older patients (median survival: 3.9 months). Poor OS was associated with B-symptoms (hazard ratio [HR] 3.89, p = 0.003) and age ≥ 60 years (HR 2.54, p = 0.034); while poor EFS was associated with ECOG-PS 2–4 (HR 2.72, p = 0.024).ConclusionsOur study revealed that R-hyperCVAD/MC was effective but associated with high early mortality in older patients. Risk-adapted regimens and prognostic factors including age, B-symptoms, and ECOG-PS are crucial for optimizing treatment.https://www.frontiersin.org/articles/10.3389/fonc.2025.1614506/fullBurkitt lymphomarituximabprognosisperformance statuschemoimmunotherapy |
| spellingShingle | Gi-June Min Ka Young Kim Tong Yoon Kim Young-Woo Jeon Byung-Su Kim Seung-Ah Yahng Ki-Seong Eom Seok-Goo Cho Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea Frontiers in Oncology Burkitt lymphoma rituximab prognosis performance status chemoimmunotherapy |
| title | Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea |
| title_full | Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea |
| title_fullStr | Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea |
| title_full_unstemmed | Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea |
| title_short | Efficacy and safety of rituximab-based chemoimmunotherapy in adult patients with Burkitt lymphoma in Korea |
| title_sort | efficacy and safety of rituximab based chemoimmunotherapy in adult patients with burkitt lymphoma in korea |
| topic | Burkitt lymphoma rituximab prognosis performance status chemoimmunotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1614506/full |
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