The outcomes of 363 patients with Burkitt Lymphoma and Burkitt’s Leukaemia (mature B cell or L3-ALL) treated with the GMALL B-ALL/NHL 2002 protocol were reported in 2014.r The complete remission (CR) rate was 88% with 5 year progression free survival (PFS) 75% and overall survival (OS) 80%. There were significant differences in CR, PFS and OS between the <55 years and >55 years groups (see table).
© Blood 2014
Multivariate analysis revealed the following factors predicted overall survival in this group of patients: age (<55 vs >55 years), bone marrow involvement, LDH, and gender.r
The GMALL B-ALL/NHL 2002 protocol has been trialled by other groups. The Northern Italy Leukemia Group (NILG) treated 105 patients with Burkitt lymphoma and leukaemia (mature B-ALL, 48%) with GMALL B-ALL/NHL 2002.r Twenty-five percent of their cohort were over 55 years old, 14% were HIV positive and 37% had an ECOG >1.r The CR rate was 79%, 3 year OS 67% and disease free survival (DFS) 75%. Outcomes were better in the younger group (<60 years), with OS 75% and DFS 82%. On multivariate analysis, the two significant indicators of prognosis were age (<60 vs >60 years) and performance status (0-1 vs >1).r
Oriol et al also reported CR rates of 84 to 88% in 36 patients with Burkitt’s lymphoma/leukaemia treated with the GMALL regimen. Nineteen (56%) of the patients were HIV positive and there were no significant differences in response rates or 2 year survival in the HIV positive, compared with negative, patients.r