Clinical Outcome of Relapsed or Refractory Burkitt Lymphoma and Mature B-Cell Lymphoblastic Leukemia in Children and Adolescentsopen access
- Authors
- Kim, Hyery; Park, Eun Sil; Lee, Soo Hyun; Koo, Hong Hoe; Kim, Hyo Sun; Lyu, Chuhl Joo; Jun, So Eun; Lim, Young Tak; Baek, Hee Jo; Kook, Hoon; Lee, Ji Won; Kang, Hyoung Jin; Park, Kyung Duk; Shin, Hee Young; Ahn, Hyeo Seop
- Issue Date
- Oct-2014
- Publisher
- KOREAN CANCER ASSOCIATION
- Keywords
- Burkitt lymphoma; Recurrence; Children
- Citation
- CANCER RESEARCH AND TREATMENT, v.46, no.4, pp 358 - 365
- Pages
- 8
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Volume
- 46
- Number
- 4
- Start Page
- 358
- End Page
- 365
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/74861
- DOI
- 10.4143/crt.2013.047
- ISSN
- 1598-2998
2005-9256
- Abstract
- Purpose Despite the rapid improvement in survival rate from Burkitt lymphoma and mature B-cell lymphoblastic leukemia (B-ALL) in children, a small subset of patients do not respond to first-line chemotherapy or experience relapse (RL). Herein, we report the clinical characteristics and outcomes of these patients. Materials and Methods RL or refractory Burkitt lymphoma and mature B-ALL in 125 patients diagnosed from 1990 to 2009 were retrospectively analyzed. Results Nineteen patients experienced RL or progressive disease (PD). Among them, 12 patients had PD or RL less than six months after initial treatment and seven had late RL. Seven patients achieved complete response (CR), 11 had PD, and one had no more therapy. Six patients who achieved CR survived without evidence of disease and four of them underwent high-dose chemotherapy (HDC) followed by stem cell transplantation (SCT). However, 11 patients who failed to obtain CR eventually died of their disease. Five-year overall survival (OS) was 31.6 +/- 10.7%. OS of patients with late RL was superior to that of patients with early RL (57.1 +/- 18.7%, vs. 16.7 +/- 10.8%, p=0.014). Achievement of CR after reinduction had significant OS (p < 0.001). OS for patients who were transplanted was superior (p < 0.01). In multivariate analysis, achievement of CR after reinduction chemotherapy showed an association with improved OS (p=0.05). Conclusion Late RL and chemotherapy-sensitive patients have the chance to achieve continuous CR using HDC/SCT, whereas patients who are refractory to retrieval therapy have poor prognosis. Therefore, novel salvage strategy is required for improvement of survival for this small set of patients.
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