Difference between revisions of "Burkitt lymphoma"
m (Text replacement - "<span style="background:#EEEE00; padding:3px 6px 3px 6px; border-color:black; border-width:2px; border-style:solid;">Phase II</span>" to "style="background-color:#EEEE00"|Phase II") |
m (Text replacement - "http://www.ncbi.nlm" to "https://www.ncbi.nlm") |
||
Line 66: | Line 66: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
# Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01317-3/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27080498 PubMed] | # Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01317-3/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27080498 PubMed] | ||
Line 103: | Line 103: | ||
===References=== | ===References=== | ||
<!-- Results previously presented at the 49th ASH Annual Meeting, Atlanta, Georgia, December 8-11, 2007. --> | <!-- Results previously presented at the 49th ASH Annual Meeting, Atlanta, Georgia, December 8-11, 2007. --> | ||
− | # Oriol A, Ribera JM, Bergua J, Giménez Mesa E, Grande C, Esteve J, Brunet S, Moreno MJ, Escoda L, Hernandez-Rivas JM, Hoelzer D. High-dose chemotherapy and immunotherapy in adult Burkitt lymphoma: comparison of results in human immunodeficiency virus-infected and noninfected patients. Cancer. 2008 Jul 1;113(1):117-25. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.23522/full link to original article] '''contains verified protocol''' [ | + | # Oriol A, Ribera JM, Bergua J, Giménez Mesa E, Grande C, Esteve J, Brunet S, Moreno MJ, Escoda L, Hernandez-Rivas JM, Hoelzer D. High-dose chemotherapy and immunotherapy in adult Burkitt lymphoma: comparison of results in human immunodeficiency virus-infected and noninfected patients. Cancer. 2008 Jul 1;113(1):117-25. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.23522/full link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/18457327 PubMed] |
=Untreated= | =Untreated= | ||
Line 145: | Line 145: | ||
===References=== | ===References=== | ||
<!-- Presented in part at the 2009 American Society of Hematology annual meeting --> | <!-- Presented in part at the 2009 American Society of Hematology annual meeting --> | ||
− | # Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. [http://informahealthcare.com/doi/full/10.3109/10428194.2012.715346 link to original article] [ | + | # Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. [http://informahealthcare.com/doi/full/10.3109/10428194.2012.715346 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234101/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/22835045 PubMed] |
==CALGB 9251 {{#subobject:975460|Regimen=1}}== | ==CALGB 9251 {{#subobject:975460|Regimen=1}}== | ||
Line 166: | Line 166: | ||
===References=== | ===References=== | ||
− | # Rizzieri DA, Johnson JL, Niedzwiecki D, Lee EJ, Vardiman JW, Powell BL, Barcos M, Bloomfield CD, Schiffer CA, Peterson BA, Canellos GP, Larson RA. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer. 2004 Apr 1;100(7):1438-48. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.20143/full link to original article] [ | + | # Rizzieri DA, Johnson JL, Niedzwiecki D, Lee EJ, Vardiman JW, Powell BL, Barcos M, Bloomfield CD, Schiffer CA, Peterson BA, Canellos GP, Larson RA. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer. 2004 Apr 1;100(7):1438-48. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.20143/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15042678 PubMed] |
==CALGB 10-002 {{#subobject:12cddc|Regimen=1}}== | ==CALGB 10-002 {{#subobject:12cddc|Regimen=1}}== | ||
Line 236: | Line 236: | ||
===References=== | ===References=== | ||
− | # Rizzieri DA, Johnson JL, Byrd JC, Lozanski G, Blum KA, Powell BL, Shea TC, Nattam S, Hoke E, Cheson BD, Larson RA; Alliance for Clinical Trials In Oncology (ACTION). Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002. Br J Haematol. 2014 Apr;165(1):102-11. Epub 2014 Jan 15. [http://onlinelibrary.wiley.com/doi/10.1111/bjh.12736/full link to original article] '''contains verified protocol''' [ | + | # Rizzieri DA, Johnson JL, Byrd JC, Lozanski G, Blum KA, Powell BL, Shea TC, Nattam S, Hoke E, Cheson BD, Larson RA; Alliance for Clinical Trials In Oncology (ACTION). Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002. Br J Haematol. 2014 Apr;165(1):102-11. Epub 2014 Jan 15. [http://onlinelibrary.wiley.com/doi/10.1111/bjh.12736/full link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/24428673 PubMed] |
==CODOX-M/IVAC {{#subobject:ef0953|Regimen=1}}== | ==CODOX-M/IVAC {{#subobject:ef0953|Regimen=1}}== | ||
Line 338: | Line 338: | ||
===References=== | ===References=== | ||
− | # Magrath I, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, Neely J, Arndt C, Nieder M, Jaffe E, Wittes RA, Horak ID. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996 Mar;14(3):925-34. [http://jco.ascopubs.org/content/14/3/925.long link to original article] '''contains verified protocol''' [ | + | # Magrath I, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, Neely J, Arndt C, Nieder M, Jaffe E, Wittes RA, Horak ID. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996 Mar;14(3):925-34. [http://jco.ascopubs.org/content/14/3/925.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/8622041 PubMed] |
− | # Mead GM, Sydes MR, Walewski J, Grigg A, Hatton CS, Pescosta N, Guarnaccia C, Lewis MS, McKendrick J, Stenning SP, Wright D; UKLG LY06 collaborators. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol. 2002 Aug;13(8):1264-74. Erratum in: Ann Oncol. 2002 Dec;13(12):1961. Norbert, P [corrected to Pescosta, N]. [http://annonc.oxfordjournals.org/content/13/8/1264.long link to original article] '''contains verified protocol''' [ | + | # Mead GM, Sydes MR, Walewski J, Grigg A, Hatton CS, Pescosta N, Guarnaccia C, Lewis MS, McKendrick J, Stenning SP, Wright D; UKLG LY06 collaborators. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol. 2002 Aug;13(8):1264-74. Erratum in: Ann Oncol. 2002 Dec;13(12):1961. Norbert, P [corrected to Pescosta, N]. [http://annonc.oxfordjournals.org/content/13/8/1264.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12181251 PubMed] |
− | # Lacasce A, Howard O, Lib S, Fisher D, Weng A, Neuberg D, Shipp M. Modified magrath regimens for adults with Burkitt and Burkitt-like lymphomas: preserved efficacy with decreased toxicity. Leuk Lymphoma. 2004 Apr;45(4):761-7. [http://informahealthcare.com/doi/abs/10.1080/1042819031000141301 link to original article] '''contains verified protocol''' [ | + | # Lacasce A, Howard O, Lib S, Fisher D, Weng A, Neuberg D, Shipp M. Modified magrath regimens for adults with Burkitt and Burkitt-like lymphomas: preserved efficacy with decreased toxicity. Leuk Lymphoma. 2004 Apr;45(4):761-7. [http://informahealthcare.com/doi/abs/10.1080/1042819031000141301 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/15160953 PubMed] |
− | # Mead GM, Barrans SL, Qian W, Walewski J, Radford JA, Wolf M, Clawson SM, Stenning SP, Yule CL, Jack AS; UK National Cancer Research Institute Lymphoma Clinical Studies Group; Australasian Leukaemia and Lymphoma Group. 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). Blood. 2008 Sep 15;112(6):2248-60. Epub 2008 Jul 8. [http://bloodjournal.hematologylibrary.org/content/112/6/2248.long link to original article] '''contains verified protocol''' [ | + | # Mead GM, Barrans SL, Qian W, Walewski J, Radford JA, Wolf M, Clawson SM, Stenning SP, Yule CL, Jack AS; UK National Cancer Research Institute Lymphoma Clinical Studies Group; Australasian Leukaemia and Lymphoma Group. 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). Blood. 2008 Sep 15;112(6):2248-60. Epub 2008 Jul 8. [http://bloodjournal.hematologylibrary.org/content/112/6/2248.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/18612102 PubMed] |
− | # Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. [http://link.springer.com/article/10.1007%2Fs12185-010-0728-0 link to original article] '''contains verified protocol''' [ | + | # Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. [http://link.springer.com/article/10.1007%2Fs12185-010-0728-0 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/21120644 PubMed] |
==COPAD {{#subobject:cc6dc7|Regimen=1}}== | ==COPAD {{#subobject:cc6dc7|Regimen=1}}== | ||
Line 375: | Line 375: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
==COPADM {{#subobject:841673|Regimen=1}}== | ==COPADM {{#subobject:841673|Regimen=1}}== | ||
Line 461: | Line 461: | ||
===References=== | ===References=== | ||
− | # '''LMB 81:''' Patte C, Philip T, Rodary C, Bernard A, Zucker JM, Bernard JL, Robert A, Rialland X, Benz-Lemoine E, Demeocq F, et al. Improved survival rate in children with stage III and IV B cell non-Hodgkin's lymphoma and leukemia using multi-agent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. J Clin Oncol. 1986 Aug;4(8):1219-26. [http://jco.ascopubs.org/content/4/8/1219.long link to original article] [ | + | # '''LMB 81:''' Patte C, Philip T, Rodary C, Bernard A, Zucker JM, Bernard JL, Robert A, Rialland X, Benz-Lemoine E, Demeocq F, et al. Improved survival rate in children with stage III and IV B cell non-Hodgkin's lymphoma and leukemia using multi-agent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. J Clin Oncol. 1986 Aug;4(8):1219-26. [http://jco.ascopubs.org/content/4/8/1219.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/3525767 PubMed] |
− | # '''LMB 84:''' Patte C, Philip T, Rodary C, Zucker JM, Behrendt H, Gentet JC, Lamagnère JP, Otten J, Dufillot D, Pein F, et al. High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol. 1991 Jan;9(1):123-32. [http://jco.ascopubs.org/content/9/1/123.long link to original article] [ | + | # '''LMB 84:''' Patte C, Philip T, Rodary C, Zucker JM, Behrendt H, Gentet JC, Lamagnère JP, Otten J, Dufillot D, Pein F, et al. High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol. 1991 Jan;9(1):123-32. [http://jco.ascopubs.org/content/9/1/123.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1985161 PubMed] |
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
# Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01317-3/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27080498 PubMed] | # Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] [http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01317-3/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27080498 PubMed] | ||
Line 523: | Line 523: | ||
===References=== | ===References=== | ||
<!-- # Dunleavy K, Little RF, Pittaluga S, Grant N, Shovlin M, Steinberg S, Yarchoan R, Janik J, Jaffe ES, Wilson WH. A prospective study of dose-adjusted (DA) EPOCH with rituximab in adults with newly diagnosed Burkitt lymphoma: a regimen with high efficacy and low toxicity. Ann Oncol 19(suppl4):83-84, abstr.9. 2008 Jun. [http://annonc.oxfordjournals.org/content/19/suppl_4.toc link to original article] '''contains protocol''' --> | <!-- # Dunleavy K, Little RF, Pittaluga S, Grant N, Shovlin M, Steinberg S, Yarchoan R, Janik J, Jaffe ES, Wilson WH. A prospective study of dose-adjusted (DA) EPOCH with rituximab in adults with newly diagnosed Burkitt lymphoma: a regimen with high efficacy and low toxicity. Ann Oncol 19(suppl4):83-84, abstr.9. 2008 Jun. [http://annonc.oxfordjournals.org/content/19/suppl_4.toc link to original article] '''contains protocol''' --> | ||
− | # Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES, Little RF, Wilson WH. Low-intensity therapy in adults with Burkitt's lymphoma. N Engl J Med. 2013 Nov 14;369(20):1915-25. [http://www.nejm.org/doi/full/10.1056/NEJMoa1308392 link to original article] [http://www.nejm.org/doi/suppl/10.1056/NEJMoa1308392/suppl_file/nejmoa1308392_appendix.pdf link to supplement] '''contains verified protocol in supplement''' [ | + | # Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES, Little RF, Wilson WH. Low-intensity therapy in adults with Burkitt's lymphoma. N Engl J Med. 2013 Nov 14;369(20):1915-25. [http://www.nejm.org/doi/full/10.1056/NEJMoa1308392 link to original article] [http://www.nejm.org/doi/suppl/10.1056/NEJMoa1308392/suppl_file/nejmoa1308392_appendix.pdf link to supplement] '''contains verified protocol in supplement''' [https://www.ncbi.nlm.nih.gov/pubmed/24224624 PubMed] |
==GMALL-B-ALL/NHL 2002 {{#subobject:2101bf|Regimen=1}}== | ==GMALL-B-ALL/NHL 2002 {{#subobject:2101bf|Regimen=1}}== | ||
Line 545: | Line 545: | ||
===References=== | ===References=== | ||
− | # Hoelzer D, Walewski J, Döhner H, Viardot A, Hiddemann W, Spiekermann K, Serve H, Dührsen U, Hüttmann A, Thiel E, Dengler J, Kneba M, Schaich M, Schmidt-Wolf IG, Beck J, Hertenstein B, Reichle A, Domanska-Czyz K, Fietkau R, Horst HA, Rieder H, Schwartz S, Burmeister T, Gökbuget N; German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014 Dec 18;124(26):3870-9. Epub 2014 Oct 30. [http://www.bloodjournal.org/content/124/26/3870 link to original article] '''contains verified protocol''' [ | + | # Hoelzer D, Walewski J, Döhner H, Viardot A, Hiddemann W, Spiekermann K, Serve H, Dührsen U, Hüttmann A, Thiel E, Dengler J, Kneba M, Schaich M, Schmidt-Wolf IG, Beck J, Hertenstein B, Reichle A, Domanska-Czyz K, Fietkau R, Horst HA, Rieder H, Schwartz S, Burmeister T, Gökbuget N; German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014 Dec 18;124(26):3870-9. Epub 2014 Oct 30. [http://www.bloodjournal.org/content/124/26/3870 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25359988 PubMed] |
==GMALL-R {{#subobject:630893|Regimen=1}}== | ==GMALL-R {{#subobject:630893|Regimen=1}}== | ||
Line 621: | Line 621: | ||
===References=== | ===References=== | ||
− | # Ribera JM, García O, Grande C, Esteve J, Oriol A, Bergua J, González-Campos J, Vall-Llovera F, Tormo M, Hernández-Rivas JM, García D, Brunet S, Alonso N, Barba P, Miralles P, Llorente A, Montesinos P, Moreno MJ, Hernández-Rivas JÁ, Bernal T. Dose-intensive chemotherapy including rituximab in Burkitt's leukemia or lymphoma regardless of human immunodeficiency virus infection status: final results of a phase 2 study (Burkimab). Cancer. 2013 May 1;119(9):1660-8. Epub 2013 Jan 29. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.27918/full link to original article] '''contains verified protocol''' [ | + | # Ribera JM, García O, Grande C, Esteve J, Oriol A, Bergua J, González-Campos J, Vall-Llovera F, Tormo M, Hernández-Rivas JM, García D, Brunet S, Alonso N, Barba P, Miralles P, Llorente A, Montesinos P, Moreno MJ, Hernández-Rivas JÁ, Bernal T. Dose-intensive chemotherapy including rituximab in Burkitt's leukemia or lymphoma regardless of human immunodeficiency virus infection status: final results of a phase 2 study (Burkimab). Cancer. 2013 May 1;119(9):1660-8. Epub 2013 Jan 29. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.27918/full link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23361927 PubMed] |
==R-CODOX-M/R-IVAC {{#subobject:2a898f|Regimen=1}}== | ==R-CODOX-M/R-IVAC {{#subobject:2a898f|Regimen=1}}== | ||
Line 689: | Line 689: | ||
===References=== | ===References=== | ||
− | # Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. [http://link.springer.com/article/10.1007%2Fs12185-010-0728-0 link to original article] '''contains verified protocol''' [ | + | # Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. [http://link.springer.com/article/10.1007%2Fs12185-010-0728-0 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/21120644 PubMed] |
− | # Barnes JA, Lacasce AS, Feng Y, Toomey CE, Neuberg D, Michaelson JS, Hochberg EP, Abramson JS. Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis. Ann Oncol. 2011 Aug;22(8):1859-64. Epub 2011 Feb 21. [http://annonc.oxfordjournals.org/content/22/8/1859.long link to original article] [ | + | # Barnes JA, Lacasce AS, Feng Y, Toomey CE, Neuberg D, Michaelson JS, Hochberg EP, Abramson JS. Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis. Ann Oncol. 2011 Aug;22(8):1859-64. Epub 2011 Feb 21. [http://annonc.oxfordjournals.org/content/22/8/1859.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/21339382 PubMed] |
− | # Jacobson C, LaCasce A. How I treat Burkitt lymphoma in adults. Blood. 2014 Nov 6;124(19):2913-20. Epub 2014 Sep 25. [http://www.bloodjournal.org/content/124/19/2913.long link to original article] '''contains verified protocol''' [ | + | # Jacobson C, LaCasce A. How I treat Burkitt lymphoma in adults. Blood. 2014 Nov 6;124(19):2913-20. Epub 2014 Sep 25. [http://www.bloodjournal.org/content/124/19/2913.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25258344 PubMed] |
==R-CODOX-M/R-IVAC (Doxil substituted) {{#subobject:4ba54c|Regimen=1}}== | ==R-CODOX-M/R-IVAC (Doxil substituted) {{#subobject:4ba54c|Regimen=1}}== | ||
Line 763: | Line 763: | ||
===References=== | ===References=== | ||
− | # Evens AM, Carson KR, Kolesar J, Nabhan C, Helenowski I, Islam N, Jovanovic B, Barr PM, Caimi PF, Gregory SA, Gordon LI. A multicenter phase II study incorporating high-dose rituximab and liposomal doxorubicin into the CODOX-M/IVAC regimen for untreated Burkitt's lymphoma. Ann Oncol. 2013 Dec;24(12):3076-81. Epub 2013 Oct 20. [http://annonc.oxfordjournals.org/content/24/12/3076.long link to original article] '''contains verified protocol''' [ | + | # Evens AM, Carson KR, Kolesar J, Nabhan C, Helenowski I, Islam N, Jovanovic B, Barr PM, Caimi PF, Gregory SA, Gordon LI. A multicenter phase II study incorporating high-dose rituximab and liposomal doxorubicin into the CODOX-M/IVAC regimen for untreated Burkitt's lymphoma. Ann Oncol. 2013 Dec;24(12):3076-81. Epub 2013 Oct 20. [http://annonc.oxfordjournals.org/content/24/12/3076.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/24146219 PubMed] |
==R-COPADM {{#subobject:c6bb81|Regimen=1}}== | ==R-COPADM {{#subobject:c6bb81|Regimen=1}}== | ||
Line 930: | Line 930: | ||
===References=== | ===References=== | ||
− | # Thomas DA, Faderl S, O'Brien S, Bueso-Ramos C, Cortes J, Garcia-Manero G, Giles FJ, Verstovsek S, Wierda WG, Pierce SA, Shan J, Brandt M, Hagemeister FB, Keating MJ, Cabanillas F, Kantarjian H. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Apr 1;106(7):1569-80. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.21776/full link to original article] '''contains verified protocol''' [ | + | # Thomas DA, Faderl S, O'Brien S, Bueso-Ramos C, Cortes J, Garcia-Manero G, Giles FJ, Verstovsek S, Wierda WG, Pierce SA, Shan J, Brandt M, Hagemeister FB, Keating MJ, Cabanillas F, Kantarjian H. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Apr 1;106(7):1569-80. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.21776/full link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16502413 PubMed] |
=Consolidation/Intensification therapy= | =Consolidation/Intensification therapy= | ||
Line 970: | Line 970: | ||
===References=== | ===References=== | ||
<!-- Presented in part at the 2009 American Society of Hematology annual meeting --> | <!-- Presented in part at the 2009 American Society of Hematology annual meeting --> | ||
− | # Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. [http://informahealthcare.com/doi/full/10.3109/10428194.2012.715346 link to original article] [ | + | # Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. [http://informahealthcare.com/doi/full/10.3109/10428194.2012.715346 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234101/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/22835045 PubMed] |
==CYM {{#subobject:b24b28|Regimen=1}}== | ==CYM {{#subobject:b24b28|Regimen=1}}== | ||
Line 1,007: | Line 1,007: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
==CYVE {{#subobject:8cd382|Regimen=1}}== | ==CYVE {{#subobject:8cd382|Regimen=1}}== | ||
Line 1,042: | Line 1,042: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
=Maintenance therapy= | =Maintenance therapy= | ||
Line 1,089: | Line 1,089: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
==COPADM {{#subobject:ffa661|Regimen=1}}== | ==COPADM {{#subobject:ffa661|Regimen=1}}== | ||
Line 1,130: | Line 1,130: | ||
===References=== | ===References=== | ||
− | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [ | + | # Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. [http://annonc.oxfordjournals.org/content/16/12/1928.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16284057 PubMed] |
[[Category:Chemotherapy regimens]] | [[Category:Chemotherapy regimens]] | ||
[[Category:Malignant hematology regimens]] | [[Category:Malignant hematology regimens]] | ||
[[Category:Lymphoma regimens]] | [[Category:Lymphoma regimens]] |
Revision as of 02:56, 2 December 2016
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer.
Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
20 regimens on this page
27 variants on this page
|
Note 1: Regimens specifically intended for HIV-related Burkitt lymphoma can be found on the HIV-associated lymphoma page.
Note 2: "Burkitt-like lymphoma" is not considered an entity by the WHO Classification of Tumours of Haematopoietic and Lymphoid Tissue 2008 criteria. The correct terminology is "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma." However, Burkitt-like lymphoma is still used in common parlance and the term is retained here; treatment is usually similar to treatment for Burkitt lymphoma but regimens evaluated on Diffuse large B-cell lymphoma are also sometimes used.
Untreated, pre-phase
COP
back to top |
COP: Cyclophosphamide, Oncovin (Vincristine), Prednisone
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II |
Ribrag et al. 2016 (LMBA-02) | Non-randomized |
This regimen is for group B (unresected stage I, non-abdominal stage II and any stage III or IV disease without CNS or bone marrow involvement) or group C (CNS and/or bone marrow involvement).
Chemotherapy
- Cyclophosphamide (Cytoxan) 300 mg/m2/day IV once on day 1
- Vincristine (Oncovin) 1 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 7
CNS prophylaxis (group B)
- Methotrexate (MTX) 15 mg IT once on day 1
- Hydrocortisone (Cortef) (dose not specified) IT once on day 1 (admixed with MTX)
CNS treatment (group C)
- Methotrexate (MTX) 15 mg IT once per day on days 1, 3, 5
- Cytarabine (Cytosar) 40 mg IT once per day on dyas 1, 3, 5
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 1, 3, 5 (admixed with MTX & Ara-C)
One cycle
Patients in LMB95 proceeded one week later to COPADM. Patients in LMBA-02 were randomized to COPADM versus R-COPADM.
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
- Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] link to original article PubMed
Cyclophosphamide & Prednisone
back to top |
Regimen
Study | Evidence |
Oriol et al. 2008 (PETHEMA) | Non-randomized |
Chemotherapy
- Cyclophosphamide (Cytoxan) 200 mg/m2/day IV over 1 hour once per day on days 1 to 5
- Prednisone (Sterapred) 60 mg/m2/day IV bolus once per day on days 1 to 5
CNS prophylaxis
- Cytarabine (Cytosar) 40 mg IT once on day 1, admixed with methotrexate and dexamethasone
- Methotrexate (MTX) 15 mg IT once on day 1, admixed with cytarabine and dexamethasone
- Dexamethasone (Decadron) 20 mg IT once on day 1, admixed with cytarabine and methotrexate
One cycle
Patients proceeded one week later to PETHEMA induction.
References
- Oriol A, Ribera JM, Bergua J, Giménez Mesa E, Grande C, Esteve J, Brunet S, Moreno MJ, Escoda L, Hernandez-Rivas JM, Hoelzer D. High-dose chemotherapy and immunotherapy in adult Burkitt lymphoma: comparison of results in human immunodeficiency virus-infected and noninfected patients. Cancer. 2008 Jul 1;113(1):117-25. link to original article contains verified protocol PubMed
Untreated
BASIC
back to top |
BASIC: Brief, Anthracycline-Sparing, Intensive Cyclophosphamide
Regimen
Study | Evidence |
Kasamon et al. 2012 | Non-randomized |
Chemotherapy
- Cyclophosphamide (Cytoxan) 1500 mg/m2 IV over 1 hour once on day 1
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1 & 8
- Methotrexate (MTX) 3000 mg/m2 IV over 2 hours once on day 8
Supportive medications
- Mesna (Mesnex) 900 mg/m2 IV "in divided doses" on day 1
- Folinic acid (Leucovorin) 25 mg/m2 IV Q6H, starting 24 hours after start of IV Methotrexate (MTX), until clearance
- Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day 3 and continuing until post-nadir ANC >500/uL
CNS prophylaxis:
- Cytarabine (Cytosar) 100 mg IT once per day on days 1, 4, 11 (also day 8 if no IV MTX given)
- Hydrocortisone (Cortef) 50 mg IT is optional (no parameters given)
14-day cycle x 2 cycles
Treatment followed immediately by BASIC intensification.
References
- Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. link to original article link to PMC article contains verified protocol PubMed
CALGB 9251
back to top |
Regimen
Study | Evidence |
Rizzieri et al. 2004 (CALGB 9251) | Phase II |
This is an earlier version of CALGB 10-002 that demonstrates that cranial radiation can be omitted in the treatment of Burkitt lymphoma. The regimen omits rituximab. We are unlikely to add this regimen to the site at this time, here for reference only.
References
- Rizzieri DA, Johnson JL, Niedzwiecki D, Lee EJ, Vardiman JW, Powell BL, Barcos M, Bloomfield CD, Schiffer CA, Peterson BA, Canellos GP, Larson RA. Intensive chemotherapy with and without cranial radiation for Burkitt leukemia and lymphoma: final results of Cancer and Leukemia Group B Study 9251. Cancer. 2004 Apr 1;100(7):1438-48. link to original article PubMed
CALGB 10-002
back to top |
Regimen
Study | Evidence |
Rizzieri et al. 2014 (CALGB 10-002) | Phase II |
Cycle 1
- Cyclophosphamide (Cytoxan) 200 mg/m2 IV once per day on days 1 to 5
- Prednisone (Sterapred) 60 mg/m2 PO once per day on days 1 to 7
Supportive medications
- Allopurinol (Zyloprim) 300 mg PO once per day on days 1 to 14 (includes first week of cycle 2)
One-week cycle, followed by alternation of the following:
Cycles 2, 4, 6
- Ifosfamide (Ifex) 800 mg/m2 IV over 1 hour once per day on days 1 to 5
- Dexamethasone (Decadron) 10 mg/m2 (route not specified) once per day on days 1 to 5
- Methotrexate (MTX) 150 mg/m2 IV load, followed by 1.35 g/m2 over 23.5 hours on day 1
- Vincristine (Oncovin) 2 mg IV push once on day 1
- Cytarabine (Cytosar) 1000 mg/m2 IV over 2 hours once per day on days 4 & 5
- Etoposide (Vepesid) 80 mg/m2 IV over 1 hour once per day on days 4 & 5
- Rituximab (Rituxan) as follows:
- Cycle 2: 50 mg/m2 IV once on day 8, then 375 mg/m2 IV once per day on days 10 & 12
- Cycles 4 & 6: 375 mg/m2 IV once on day 8
CNS prophylaxis (for patients without CNS involvement):
- Cytarabine (Cytosar) 40 mg intrathecal on day 1
- Methotrexate (MTX) 15 mg intrathecal on day 1
- Hydrocortisone (Cortef) 50 mg intrathecal on day 1
Supportive medications
- Mesna (Mesnex) (dose not specified but presumably equal to ifosfamide dose) mixed with Ifosfamide (Ifex)
- Folinic acid (Leucovorin) 25 mg/m2 IV or PO once 36 hours after start of IV Methotrexate (MTX), then 10 mg/m2 Q6H until methotrexate level < 0.05
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 7 and continuing until ANC > 500/uL
21-day cycles
Cycles 3, 5, 7
- Cyclophosphamide (Cytoxan) 200 mg/m2 IV once per day on days 1 to 5
- Dexamethasone (Decadron) 10 mg/m2 PO or IV once per day on days 1 to 5
- Methotrexate (MTX) 150 mg/m2 IV load, followed by 1.35 g/m2 over 23.5 hours on day 1
- Vincristine (Oncovin) 2 mg IV push once on day 1
- Doxorubicin (Adriamycin) 25 mg/m2 IV once per day on days 4 & 5
- Rituximab (Rituxan) 375 mg/m2 IV once on day 8 of cycles 3, 5, 7
CNS prophylaxis (for patients without CNS involvement):
- Cytarabine (Cytosar) 40 mg intrathecal on day 1
- Methotrexate (MTX) 15 mg intrathecal on day 1
- Hydrocortisone (Cortef) 50 mg intrathecal on day 1
Supportive medications
- Folinic acid (Leucovorin) 50 mg/m2 IV or PO once 36 hours after start of IV Methotrexate (MTX), then 10 mg/m2 Q6H until methotrexate level < 0.05
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 7 and continuing until ANC > 500/uL
21-day cycles
References
- Rizzieri DA, Johnson JL, Byrd JC, Lozanski G, Blum KA, Powell BL, Shea TC, Nattam S, Hoke E, Cheson BD, Larson RA; Alliance for Clinical Trials In Oncology (ACTION). Improved efficacy using rituximab and brief duration, high intensity chemotherapy with filgrastim support for Burkitt or aggressive lymphomas: cancer and Leukemia Group B study 10 002. Br J Haematol. 2014 Apr;165(1):102-11. Epub 2014 Jan 15. link to original article contains verified protocol PubMed
CODOX-M/IVAC
back to top |
CODOX-M: Cyclophosphamide, Oncovin (Vincristine), DOXorubicin, Methotrexate
IVAC: Ifosfamide, Vepesid (Etoposide), Ara-C (Cytarabine)
Regimen #1, "Original Magrath"
Study | Evidence |
Magrath et al. 1996 | Phase II |
Part 1: CODOX-M
- Cyclophosphamide (Cytoxan) 800 mg/m2 IV once on day 1, then 200 mg/m2 IV once per day on days 2 to 5
- Vincristine (Oncovin) 1.5 mg/m2 IV once per day on days 1 & 8
- Doxorubicin (Adriamycin) 40 mg/m2 IV once on day 1
- Methotrexate (MTX) as follows:
- Age 65 years or younger: 300 mg/m2 IV over 1 hour, then 2700 mg/m2 IV over the next 23 hours on day 10 (total dose: 3000 mg/m2)
- Age >65 years: 100 mg/m2 IV over 1 hour, then 900 mg/m2 IV over the next 23 hours on day 10 (total dose: 1000 mg/m2)
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 IV Q3H, starting 36 hours after start of IV Methotrexate (MTX) until 48 hours, then Q6H until methotrexate level undetectable
- Folinic acid (Leucovorin) 15 mg PO once 24 hours after intrathecal Methotrexate (MTX)
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 13 and continuing until ANC >1,000/uL
CNS prophylaxis:
- Cytarabine (Cytosar) 70 mg IT once per day on days 1 & 3
- Methotrexate (MTX) 12 mg IT once on day 15
Part 2: IVAC
- Ifosfamide (Ifex) as follows:
- Age 65 years or younger: 1500 mg/m2 IV over 1 hour once per day on days 1 to 5
- Age >65 years: 1000 mg/m2 IV over 1 hour once per day on days 1 to 5
- Etoposide (Vepesid) 60 mg/m2 IV over 1 hour once per day on days 1 to 5
- Cytarabine (Cytosar) as follows:
- Age 65 years or younger: 2000 mg/m2 IV over 3 hours Q12H on days 1,2 (4 doses)
- Age >65 years: 1000 mg/m2 IV over 3 hours Q12H on days 1,2 (4 doses)
Supportive medications
- Mesna (Mesnex) as follows:
- Age 65 years or younger: 300 mg/m2 (mixed with Ifosfamide (Ifex)) over 1 hour, then 300mg/m2 IV every four hours x 2, on days 1 to 5
- Age >65 years: 200 mg/m2 (mixed with Ifosfamide (Ifex)) over 1 hour, then 200mg/m2 IV every four hours x 2, on days 1 to 5
- Folinic acid (Leucovorin) 15 mg PO once 24 hours after intrathecal methotrexate
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 7 and continuing until ANC >1,000/uL
CNS prophylaxis:
- Methotrexate (MTX) 12 mg IT once on day 5
Regimen #2, "Modified Magrath"
Study | Evidence |
LaCasce et al. 2004 | Phase II, <20 patients reported |
All modifications are in Part 1: CODOX-M. Also note that dose reductions for age > 65 years were not described in this publication.
Part 1: CODOX-M
- Cyclophosphamide (Cytoxan) 800 mg/m2 IV once per day on days 1 & 2
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once per day on days 1 & 10
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Methotrexate (MTX) 3000 mg/m2 IV once on day 10
CNS prophylaxis (all treatments admixed with 50 mg Hydrocortisone (Cortef)):
- Cytarabine (Cytosar) 50 mg intrathecal on days 1 (all patients), day 3 (high-risk only)
- Methotrexate (MTX) 12 mg intrathecal on day 1
Supportive medications
- Folinic acid (Leucovorin) 200 mg/m2 IV once 24 hours after start of IV Methotrexate (MTX), then 15 mg/m2 Q6H until methotrexate level undetectable
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day on days 3 to 8, held for MTX, and restarted after clearance continuing until ANC >1,000/uL
Part 2: IVAC
- Ifosfamide (Ifex) 1500 mg/m2 IV over 1 hour once per day on days 1 to 5
- Etoposide (Vepesid) 60 mg/m2 IV over 1 hour once per day on days 1 to 5
- Cytarabine (Cytosar) 2 g/m2 IV over 3 hours Q12H on days 1,2 (4 doses)
CNS prophylaxis:
- Methotrexate (MTX) 12 mg admixed with 50 mg Hydrocortisone (Cortef) intrathecal on day 5
Supportive medications
- Mesna (Mesnex) 300 mg/m2 (mixed with Ifosfamide (Ifex)) over 1 hour, then 300mg/m2 IV every four hours x 2, on days 1 to 5
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 6 and continuing until ANC >1,000/uL
High-risk patients receive 2 cycles each of R-CODOX-M and R-IVAC (alternating). Low-risk patients (i.e. single site of disease <10cm with normal LDH) receive 3 cycles of R-CODOX-M.
References
- Magrath I, Adde M, Shad A, Venzon D, Seibel N, Gootenberg J, Neely J, Arndt C, Nieder M, Jaffe E, Wittes RA, Horak ID. Adults and children with small non-cleaved-cell lymphoma have a similar excellent outcome when treated with the same chemotherapy regimen. J Clin Oncol. 1996 Mar;14(3):925-34. link to original article contains verified protocol PubMed
- Mead GM, Sydes MR, Walewski J, Grigg A, Hatton CS, Pescosta N, Guarnaccia C, Lewis MS, McKendrick J, Stenning SP, Wright D; UKLG LY06 collaborators. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt's lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol. 2002 Aug;13(8):1264-74. Erratum in: Ann Oncol. 2002 Dec;13(12):1961. Norbert, P [corrected to Pescosta, N]. link to original article contains verified protocol PubMed
- Lacasce A, Howard O, Lib S, Fisher D, Weng A, Neuberg D, Shipp M. Modified magrath regimens for adults with Burkitt and Burkitt-like lymphomas: preserved efficacy with decreased toxicity. Leuk Lymphoma. 2004 Apr;45(4):761-7. link to original article contains verified protocol PubMed
- Mead GM, Barrans SL, Qian W, Walewski J, Radford JA, Wolf M, Clawson SM, Stenning SP, Yule CL, Jack AS; UK National Cancer Research Institute Lymphoma Clinical Studies Group; Australasian Leukaemia and Lymphoma Group. 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). Blood. 2008 Sep 15;112(6):2248-60. Epub 2008 Jul 8. link to original article contains verified protocol PubMed
- Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. link to original article contains verified protocol PubMed
COPAD
back to top |
COPAD: Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin)
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II, <20 pts in this arm |
This regimen is for group A (completely resected stage I or abdominal stage II disease).
Chemotherapy
- Cyclophosphamide (Cytoxan) 500 mg/m2/day IV (in 2 fractions) on days 2 to 4
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once per day on days 1 & 6
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 6
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
3 cycles; intervals were as short as possible, as soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
COPADM
back to top |
COPADM: Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin), Methotrexate
Regimen
Study | Evidence | Comparator | Efficacy |
Diviné et al. 2005 (LMB95) | Phase II | ||
Ribrag et al. 2016 (LMBA-02) | Phase III | R-COPADM | Seems to have inferior EFS |
This regimen is for group B (unresected stage I, non-abdominal stage II and any stage III or IV disease without CNS or bone marrow involvement) or group C (CNS and/or bone marrow involvement). Diviné et al. 2005 list the dose of HD-MTX as 3 mg/m2 but this is presumed to be a typo. Treatment is preceded by pre-phase COP.
COPADM #1
- Cyclophosphamide (Cytoxan) 500 mg/m2/day IV (in 2 fractions) on days 2 to 4
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 6
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis (group B)
- Methotrexate (MTX) 15 mg IT once per day on days 2 & 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2 & 6 (admixed with MTX)
CNS treatment (group C)
- Methotrexate (MTX) 15 mg IT once per day on days 2, 4, 6
- Cytarabine (Cytosar) 40 mg IT once per day on dyas 2, 4, 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2, 4, 6 (admixed with MTX & Ara-C)
One cycle
As soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L, patients proceeded to:
COPADM #2
- Cyclophosphamide (Cytoxan) 1000 mg/m2/day IV (in 2 fractions) on days 2 to 4
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once per day on days 1 & 6
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 6
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis (group B)
- Methotrexate (MTX) 15 mg IT once per day on days 2 & 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2 & 6 (admixed with MTX)
CNS treatment (group C)
- Methotrexate (MTX) 15 mg IT once per day on days 2, 4, 6
- Cytarabine (Cytosar) 40 mg IT once per day on dyas 2, 4, 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2, 4, 6 (admixed with MTX & Ara-C)
One cycle
As soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L, patients in group B proceeded to CYM consolidation, and patients in group C proceeded to CYVE consolidation.
References
- LMB 81: Patte C, Philip T, Rodary C, Bernard A, Zucker JM, Bernard JL, Robert A, Rialland X, Benz-Lemoine E, Demeocq F, et al. Improved survival rate in children with stage III and IV B cell non-Hodgkin's lymphoma and leukemia using multi-agent chemotherapy: results of a study of 114 children from the French Pediatric Oncology Society. J Clin Oncol. 1986 Aug;4(8):1219-26. link to original article PubMed
- LMB 84: Patte C, Philip T, Rodary C, Zucker JM, Behrendt H, Gentet JC, Lamagnère JP, Otten J, Dufillot D, Pein F, et al. High survival rate in advanced-stage B-cell lymphomas and leukemias without CNS involvement with a short intensive polychemotherapy: results from the French Pediatric Oncology Society of a randomized trial of 216 children. J Clin Oncol. 1991 Jan;9(1):123-32. link to original article PubMed
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
- Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] link to original article PubMed
DA-R-EPOCH
back to top |
DA-R-EPOCH: Dose Adjusted Rituximab, Etoposide, Prednisone, Oncovin (Vincristine), Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin)
Synonyms: DA-EPOCH-R, EPOCH-R, REPOCH
Structured Concept: C63461 (NCI-T), C1882521 (NCI-MT/UMLS)
Regimen
Study | Evidence |
Dunleavy et al. 2013 | Phase II, <20 pts in this arm |
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV over 3 hours once on day 1
- Etoposide (Vepesid) 50 mg/m2/day IV continuous infusion on days 1 to 4 (total dose of 200 mg/m2)
- Prednisone (Sterapred) 60 mg/m2 PO BID on days 1 to 5
- Vincristine (Oncovin) 0.4 mg/m2/day IV continuous infusion on days 1 to 4 (total dose of 1.6 mg/m2)
- Cyclophosphamide (Cytoxan) 750 mg/m2 IV over 2 hours once on day 5
- Doxorubicin (Adriamycin) 10 mg/m2/day IV continuous infusion on days 1 to 4 (total dose of 40 mg/m2)
Supportive medications
- Filgrastim (Neupogen) 300 mcg SC once per day, starting on day 6 and continuing until ANC greater than 5×109/L above the nadir level
- Trimethoprim/Sulfamethoxazole (Bactrim DS) one tablet PO TIW
- Omeprazole (Prilosec) 20 mg PO once per day or equivalent
- Docusate (Colace), Sennosides (Senna), and Lactulose as needed for constipation
21-day cycle x 6 cycles if ANC >1,000 and platelets >100
If counts are below those levels, check daily CBC and continue growth factor support until counts are adequate and next cycle can start.
Dose-adjustments for EPOCH protocol (note this is different than some other DA-EPOCH regimens):
- Start cycle 1 as described above.
- Obtain CBCs twice per week for nadir measurements.
- If nadir ANC ≥500, increase etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
- If nadir ANC <500, use same doses as last cycle.
- If nadir platelet count <25, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
- Decreases below the cycle 1 starting dose only apply to cyclophosphamide, i.e., the lowest etoposide and doxorubicin would be dosed is at the original cycle 1 dose.
CNS prophylaxis
- Methotrexate (MTX) as follows:
- Cycles 3 to 6: 12 mg IT once per day on days 1 & 5
References
- Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES, Little RF, Wilson WH. Low-intensity therapy in adults with Burkitt's lymphoma. N Engl J Med. 2013 Nov 14;369(20):1915-25. link to original article link to supplement contains verified protocol in supplement PubMed
GMALL-B-ALL/NHL 2002
back to top |
GMALL: German Multicenter Study Group for the Treatment of Adult Acute Lymphoblastic Leukemia
Regimen
Study | Evidence |
Hoelzer et al. 2014 (GMALL-B-ALL/NHL 2002) | Non-randomized |
This regimen is fairly similar to the GMALL-R regimen, with some minor differences. See text for details.
References
- Hoelzer D, Walewski J, Döhner H, Viardot A, Hiddemann W, Spiekermann K, Serve H, Dührsen U, Hüttmann A, Thiel E, Dengler J, Kneba M, Schaich M, Schmidt-Wolf IG, Beck J, Hertenstein B, Reichle A, Domanska-Czyz K, Fietkau R, Horst HA, Rieder H, Schwartz S, Burmeister T, Gökbuget N; German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014 Dec 18;124(26):3870-9. Epub 2014 Oct 30. link to original article contains verified protocol PubMed
GMALL-R
back to top |
GMALL-R: German Multicenter Study Group for the Treatment of Adult Acute Lymphoblastic Leukemia, Rituximab
Regimen
Study | Evidence |
Ribera et al. 2013 (Burkimab) | Phase II |
Numbering of days is based on prephase->A->B->C; however, certain patient populations received different ordering of regimen, see below.
Prephase
- Cyclophosphamide (Cytoxan) 200 mg/m2 IV over 1 hour once per day on days 1 to 5
- Prednisone (Sterapred) 60 mg/m2 IV bolus once per day on days 1 to 5
Cycle A
- Rituximab (Rituxan) 375 mg/m2 IV over 4 hours once on day 7
- Vincristine (Oncovin) 2 mg IV bolus once on day 8
- Methotrexate (MTX) 1500 mg/m2 IV over 24 hours once on day 8
- Older than 55 years: reduce Methotrexate (MTX) dose by 50%
- Ifosfamide (Ifex) 800 mg/m2 IV over 1 hour once per day on days 8 to 12
- Dexamethasone (Decadron) 10 mg/m2 IV bolus once per day on days 8 to 12
- Teniposide (Vumon) 100 mg/m2 IV over 1 hour once per day on days 11 & 12
- Cytarabine (Cytosar) 150 mg/m2 IV over 1 hour BID on days 11 & 12
- Older than 55 years: reduce Cytarabine (Cytosar) dose by 50%
Supportive medications
- Folinic acid (Leucovorin) (dose/route/schedule not specified), starting 12 hours after Methotrexate (MTX) infusion
Cycle B
- Rituximab (Rituxan) 375 mg/m2 IV over 4 hours once on day 28
- Vincristine (Oncovin) 2 mg IV bolus once on day 29
- Methotrexate (MTX) 1500 mg/m2 IV over 24 hours once on day 29
- Older than 55 years: reduce Methotrexate (MTX) dose by 50%
- Cyclophosphamide (Cytoxan) 200 mg/m2 IV over 1 hour once per day on days 29 to 33
- Dexamethasone (Decadron) 10 mg/m2 IV bolus once per day on days 29 to 33
- Doxorubicin (Adriamycin) 25 mg/m2 IV over 15 minutes once per day on days 32 & 33
Supportive medications
- Folinic acid (Leucovorin) (dose/route/schedule not specified), starting 12 hours after Methotrexate (MTX) infusion
Cycle C
- Rituximab (Rituxan) 375 mg/m2 IV over 4 hours once on day 49
- Vindesine (Eldisine) 3 mg/m2 (maximum dose 5 mg) IV bolus once on day 50
- Methotrexate (MTX) 1500 mg/m2 IV over 24 hours once on day 50
- Older than 55 years: reduce Methotrexate (MTX) dose by 50%
- Dexamethasone (Decadron) 10 mg/m2 IV bolus once per day on days 50 to 54
- Etoposide (Vepesid) 250 mg/m2 IV over 1 hour once per day on days 53 & 54
- Cytarabine (Cytosar) 2000 mg/m2 IV over 3 hours BID on day 54
- Older than 55 years: reduce Cytarabine (Cytosar) dose by 50%
Supportive medications
- Folinic acid (Leucovorin) (dose/route/schedule not specified), starting 12 hours after Methotrexate (MTX) infusion
Give regimen as follows:
- Advanced stage and younger than 55 years: A->B->C x 2 courses (6 total cycles)
- Older than 55 years: Alternate A & B x 3 courses (6 total cycles)
- Localized stage: 4 total cycles (unclear from protocol if this means A alternating with B or A->B->C->A)
CNS Prophylaxis
- Methotrexate (MTX) 15 mg intrathecal once on days 1, 8, 12, 29, 33
- Cytarabine (Cytosar) 40 mg intrathecal once on days 1, 8, 12, 29, 33
- Dexamethasone (Decadron) 20 mg intrathecal once on days 1, 8, 12, 29, 33
8 doses total
References
- Ribera JM, García O, Grande C, Esteve J, Oriol A, Bergua J, González-Campos J, Vall-Llovera F, Tormo M, Hernández-Rivas JM, García D, Brunet S, Alonso N, Barba P, Miralles P, Llorente A, Montesinos P, Moreno MJ, Hernández-Rivas JÁ, Bernal T. Dose-intensive chemotherapy including rituximab in Burkitt's leukemia or lymphoma regardless of human immunodeficiency virus infection status: final results of a phase 2 study (Burkimab). Cancer. 2013 May 1;119(9):1660-8. Epub 2013 Jan 29. link to original article contains verified protocol PubMed
R-CODOX-M/R-IVAC
back to top |
R-CODOX-M: Rituximab, Cyclophosphamide, Oncovin (Vincristine), DOXorubicin, Methotrexate
R-IVAC: Rituximab, Ifosfamide, Vepesid (etoposide), Ara-C (Cytarabine)
Regimen
Study | Evidence |
Jacobson et al. 2014 | Expert Recommendation |
In the Jacobson et al. 2014 review, the authors describe a "Modified Magrath regimen of R-CODOX/R-IVAC" based on the timing and dosage of LaCasce et al. 2004. However, LaCasce et al. 2004 did not include rituximab in the schema. Others have published retrospective series of this regimen; doses here are based on the review article.
Part 1: R-CODOX-M
- Rituximab (Rituxan) as follows:
- Cycle 1: 375 mg/m2 IV once no earlier than day 3
- Cycle 2 onwards: 375 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 800 mg/m2 IV once per day on days 1 & 2
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once per day on days 1 & 15
- Doxorubicin (Adriamycin) 50 mg/m2 IV once on day 1
- Methotrexate (MTX) 3000 mg/m2 IV over 2 to 4 hours once on day 15
CNS Prophylaxis:
- Cytarabine (Cytosar) 50 mg intrathecal once on day 1 (admixed with MTX) and again on day 3 in high-risk patients
- Methotrexate (MTX) 12 mg intrathecal once on day 1
CNS Treatment (for CSF positive): Treatment as per CNS prophylaxis PLUS:
- Cytarabine (Cytosar) 50 mg intrathecal once on day 5 of cycle 1 only
- Methotrexate (MTX) 12 mg intrathecal once on day 15 of cycle 1 only
Supportive medications
- Folinic acid (Leucovorin) 200 mg/m2 IV once 24 hours after start of IV Methotrexate (MTX), then 15 mg/m2 Q6H until methotrexate level undetectable
- Pegfilgrastim (Neulasta) 6 mg SC once on day 3
Part 2: R-IVAC
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
- Ifosfamide (Ifex) 1500 mg/m2 IV over 2 hours once per day on days 1 to 5
- Etoposide (Vepesid) 60 mg/m2 IV over 1 hour once per day on days 1 to 5
- Cytarabine (Cytosar) 2 g/m2 IV over 3 hours Q12H on days 1 & 2 (4 doses total)
CNS Prophylaxis:
- Methotrexate (MTX) 12 mg intrathecal once on day 5
CNS Treatment (for CSF positive): Treatment as per CNS prophylaxis PLUS:
- Cytarabine (Cytosar) 50 mg intrathecal once on day 3 of cycle 1 only
Supportive medications
- Mesna (Mesnex) 300 mg/m2 (mixed with Ifosfamide (Ifex)) over 1 hour, then 300mg/m2 IV every four hours x 2, on days 1 to 5
- Pegfilgrastim (Neulasta) 6 mg SC once on day 6
Patients with "extensive disease and elevated LDH" receive 2 cycles each of R-CODOX-M and R-IVAC (alternating). Patients with low-risk disease (i.e. single site of disease <10cm with normal LDH) receive 3 cycles of R-CODOX-M.
References
- Maruyama D, Watanabe T, Maeshima AM, Nomoto J, Taniguchi H, Azuma T, Mori M, Munakata W, Kim SW, Kobayashi Y, Matsuno Y, Tobinai K. Modified cyclophosphamide, vincristine, doxorubicin, and methotrexate (CODOX-M)/ifosfamide, etoposide, and cytarabine (IVAC) therapy with or without rituximab in Japanese adult patients with Burkitt lymphoma (BL) and B cell lymphoma, unclassifiable, with features intermediate between diffuse large B cell lymphoma and BL. Int J Hematol. 2010 Dec;92(5):732-43. Epub 2010 Dec 1. link to original article contains verified protocol PubMed
- Barnes JA, Lacasce AS, Feng Y, Toomey CE, Neuberg D, Michaelson JS, Hochberg EP, Abramson JS. Evaluation of the addition of rituximab to CODOX-M/IVAC for Burkitt's lymphoma: a retrospective analysis. Ann Oncol. 2011 Aug;22(8):1859-64. Epub 2011 Feb 21. link to original article PubMed
- Jacobson C, LaCasce A. How I treat Burkitt lymphoma in adults. Blood. 2014 Nov 6;124(19):2913-20. Epub 2014 Sep 25. link to original article contains verified protocol PubMed
R-CODOX-M/R-IVAC (Doxil substituted)
back to top |
R-CODOX-M: Rituximab, Cyclophosphamide, Oncovin, DOXil, M ethotrexate
R-IVAC: Rituximab, Ifosfamide, Vepesid (etoposide), AC Ara-C (cytarabine)
Regimen
Study | Evidence |
Evens et al. 2013 | Phase II |
Low risk patients (R-CODOX-M alone)
- Rituximab (Rituxan) 500 mg/m2 IV once on days 0 & 8
- Cyclophosphamide (Cytoxan) 800 mg/m2 IV over 1 hour once on day 1; 200 mg/m2 IV over 1 hour once per day on days 2 to 5
- Vincristine (Oncovin) 1.5 mg/m2 (max dose of 2 mg) IV push once on days 1 & 8
- Doxorubicin liposomal (Doxil) 40 mg/m2 IV once "per protocol" on day 1
- Methotrexate (MTX) 300 mg/m2 IV over 1 hour, followed by 2700 mg/m2 IV over next 23 hours on day 10
CNS Prophylaxis:
- Cytarabine (Cytosar) 70 mg intrathecal once on day 1
- Methotrexate (MTX) 12 mg intrathecal (or 6 mg into Ommaya) once on day 3
Supportive medications
- Folinic acid (Leucovorin) 200 mg/m2 IV once 36 hours after start of IV Methotrexate (MTX), then 15 mg/m2 IV Q6H until methotrexate level is <5 X 10-8
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day on days 6 & 7, then on day 14 onwards until ANC >1,500/uL
3 consecutive cycles
High risk patients
Part 1: R-CODOX-M
- Rituximab (Rituxan) 500 mg/m2 IV once on days 0 & 8
- Cyclophosphamide (Cytoxan) 800 mg/m2 IV over 1 hour once on day 1; 200 mg/m2 IV over 1 hour once per day on days 2 to 5
- Vincristine (Oncovin) 1.5 mg/m2 (max dose of 2 mg) IV push once on days 1 & 8
- Doxorubicin liposomal (Doxil) 40 mg/m2 IV once "per protocol" on day 1
- Methotrexate (MTX) 300 mg/m2 IV over 1 hour, followed by 2700 mg/m2 IV over next 23 hours on day 10
CNS Prophylaxis:
- Cytarabine (Cytosar) 70 mg intrathecal once on days 1 & 3
- Methotrexate (MTX) 12 mg intrathecal (or 6 mg into Ommaya) once on day 15
Supportive medications
- Folinic acid (Leucovorin) 200 mg/m2 IV once 36 hours after start of IV Methotrexate (MTX), then 15 mg/m2 IV Q6H until methotrexate level is <5 X 10-8
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day on days 6 & 7, then on day 14 onwards until ANC >1,500/uL
Part 2: R-IVAC
- Rituximab (Rituxan) 375 mg/m2 IV on days 0 & 6 or 7 (2 doses per cycle)
- Ifosfamide (Ifex) 1500 mg/m2 IV over 3 hours once per day on days 1 to 5
- Etoposide (Vepesid) 60 mg/m2 IV over 1 hour once per day on days 1 to 5
- Cytarabine (Cytosar) 2 g/m2 IV over 3 hours Q12H on days 1,2 (4 doses per cycle)
CNS Prophylaxis:
- Methotrexate (MTX) 15 mg intrathecal once on day 5
Supportive medications
- Mesna (Mesnex) 500 mg/m2 mixed with first Ifosfamide (Ifex), then 1000 mg/m2/day IV continuous infusion on days 1 to 5
- Folinic acid (Leucovorin) 15 mg PO q6h x 4 doses, starting 24 hours after intrathecal Methotrexate (MTX)
- Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 6 or 7 and continuing until ANC >1,500/uL
Four alternating cycles of R-CODOX-M & R-IVAC
References
- Evens AM, Carson KR, Kolesar J, Nabhan C, Helenowski I, Islam N, Jovanovic B, Barr PM, Caimi PF, Gregory SA, Gordon LI. A multicenter phase II study incorporating high-dose rituximab and liposomal doxorubicin into the CODOX-M/IVAC regimen for untreated Burkitt's lymphoma. Ann Oncol. 2013 Dec;24(12):3076-81. Epub 2013 Oct 20. link to original article contains verified protocol PubMed
R-COPADM
back to top |
R-COPADM: Rituximab, Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin), Methotrexate
Regimen
Study | Evidence | Comparator | Efficacy |
Ribrag et al. 2016 (LMBA-02) | Phase III | COPADM | Seems to have superior EFS |
This regimen is for group B (unresected stage I, non-abdominal stage II and any stage III or IV disease without CNS or bone marrow involvement) or group C (CNS and/or bone marrow involvement). Diviné et al. 2005 list the dose of HD-MTX as 3 mg/m2 but this is presumed to be a typo. Treatment is preceded by pre-phase COP.
COPADM #1
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1 & 6
- Cyclophosphamide (Cytoxan) 500 mg/m2/day IV (in 2 fractions) on days 2 to 4
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 6
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis (group B)
- Methotrexate (MTX) 15 mg IT once per day on days 2 & 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2 & 6 (admixed with MTX)
CNS treatment (group C)
- Methotrexate (MTX) 15 mg IT once per day on days 2, 4, 6
- Cytarabine (Cytosar) 40 mg IT once per day on dyas 2, 4, 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2, 4, 6 (admixed with MTX & Ara-C)
One cycle
As soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L, patients proceeded to:
COPADM #2
- Rituximab (Rituxan) 375 mg/m2 IV once per day on days 1 & 6
- Cyclophosphamide (Cytoxan) 1000 mg/m2/day IV (in 2 fractions) on days 2 to 4
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once per day on days 1 & 6
- Prednisone (Sterapred) 60 mg/m2/day PO/IV on days 1 to 6
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis (group B)
- Methotrexate (MTX) 15 mg IT once per day on days 2 & 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2 & 6 (admixed with MTX)
CNS treatment (group C)
- Methotrexate (MTX) 15 mg IT once per day on days 2, 4, 6
- Cytarabine (Cytosar) 40 mg IT once per day on dyas 2, 4, 6
- Hydrocortisone (Cortef) (dose not specified) IT once per day on days 2, 4, 6 (admixed with MTX & Ara-C)
One cycle
As soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L, patients in group B proceeded to CYM consolidation, and patients in group C proceeded to CYVE consolidation.
References
- Ribrag V, Koscielny S, Bosq J, Leguay T, Casasnovas O, Fornecker LM, Recher C, Ghesquieres H, Morschhauser F, Girault S, Gouill SL, Ojeda-Uribe M, Mariette C, Cornillon J, Cartron G, Verge V, Chassagne-Clément C, Dombret H, Coiffier B, Lamy T, Tilly H, Salles G. Rituximab and dose-dense chemotherapy for adults with Burkitt's lymphoma: a randomised, controlled, open-label, phase 3 trial. Lancet. 2016 Apr 11. [Epub ahead of print] link to original article PubMed
R-HyperCVAD/R-MA
back to top |
R-HyperCVAD: Rituximab, Hyperfractionated Cyclophosphamide, Vincristine, Adriamycin (Doxorubicin), Dexamethasone
R-MA: Rituximab, Methotrexate, Ara-C (Cytarabine)
Regimen
Study | Evidence |
Thomas et al. 2006 | Pilot, <20 patients reported |
Part A (cycles 1, 3, 5, 7)
- Rituximab (Rituxan) as follows:
- Cycles 1 & 3: 375 mg/m2 IV over 2 to 6 hours once per day on days 1 & 11
- Cyclophosphamide (Cytoxan) 300 mg/m2 IV over 2 hours Q12H on days 1 to 3 (6 total doses)
- Vincristine (Oncovin) 2 mg IV once per day on days 4 & 11
- Doxorubicin (Adriamycin) 50 mg/m2/day IV continuous infusion on day 4 (total dose: 50 mg/m2)
- Dexamethasone (Decadron) 40 mg PO/IV once per day on days 1 to 4, 11 to 14
CNS prophylaxis
- Methotrexate (MTX) 12 mg (6 mg if given via Ommaya reservoir) IT once on day 2
- Cytarabine (Cytosar) 100 mg IT once on day 7
Given each cycle for a total of 16 intrathecal treatments. If CNS disease present, therapy augmented to twice-weekly alternating (MTX, ara-C) treatments until CSF cell count normalizes and cytology is negative, then continues for 4 more alternating weekly treatments; prophylaxis course then resumes.
Supportive care:
- Mesna (Mesnex) 600 mg/m2/day IV continuous infusion on days 1 to 3, starting 1 hour before Cyclophosphamide (Cytoxan) and completed 12 hours after the last dose of Cyclophosphamide (Cytoxan)
- Filgrastim (Neupogen) 10 mcg/kg SC once per day starting 24 hours after completion of chemotherapy, given until WBC >3 x 10^9/L or bone pain present
- One of the following antibiotics:
- EITHER Quinolone
- OR Trimethoprim/Sulfamethoxazole (Bactrim DS) (160/800 mg) dose/route not specified
- Fluconazole (Diflucan) dose/route not specified
- One of the following antivirals:
- EITHER Acyclovir (Zovirax) dose/route not specified
- OR Valacyclovir (Valtrex) dose/route not specified
Dose modifications:
- Vincristine (Oncovin) reduced to 1 mg for bilirubin > 2 mg/dL or NCI common toxicity criteria Grade 2+ peripheral neuropathy, omitted for bilirubin > 3 mg/dL or for ileus
- Doxorubicin (Adriamycin) reduced by 50% for bilirubin 2 to 3 mg/dL, by 75% for bilirubin 3 to 5 mg/dL (eliminated for bilirubin > 5 mg/dL or for gastric/small-bowel involvement with Course 1 to reduce duration of myelosuppression given risk of perforation)
Next cycle to start no sooner than 14 days or as soon as "unmaintained" WBC count is > 3 x 10^9/L and platelet count > 50 x 10^9/L
Part B (cycles 2, 4, 6, 8)
- Rituximab (Rituxan) as follows:
- Cycles 2 & 4: 375 mg/m2 IV over 2 to 6 hours once per day on days 2 & 8
- Methotrexate (MTX) 1000 mg/m2/day IV continuous infusion on day 1 (total dose: 1000 mg/m2)
- Cytarabine (Cytosar) 3000 mg/m2 IV over 2 hours Q12H on days 2 & 3 (4 total doses)
CNS prophylaxis
- Methotrexate (MTX) 12 mg (6 mg if given via Ommaya reservoir) IT once on day 2
- Cytarabine (Cytosar) 100 mg IT once on day 7
Given each cycle for a total of 16 intrathecal treatments. If CNS disease present, therapy augmented to twice-weekly alternating (MTX, ara-C) treatments until CSF cell count normalizes and cytology is negative, then continues for 4 more alternating weekly treatments; prophylaxis course then resumes.
Supportive care:
- Folinic acid (Leucovorin) 50 mg IV x1 12 hours after Methotrexate (MTX) is complete, then 15 mg IV Q6H x 8 doses until serum methotrexate level <0.1 µM
- Filgrastim (Neupogen) 10 mcg/kg SC once per day starting 24 hours after completion of chemotherapy, given until WBC >3 x 10^9/L or bone pain present
- One of the following antibiotics:
- EITHER Quinolone
- OR Trimethoprim/Sulfamethoxazole (Bactrim DS) (160/800 mg) dose/route not specified
- Fluconazole (Diflucan) dose/route not specified
- One of the following antivirals:
- EITHER Acyclovir (Zovirax) dose/route not specified
- OR Valacyclovir (Valtrex) dose/route not specified
Dose modifications:
- Cytarabine (Cytosar) reduced to 1000 mg/m2 for patients =60 years old, creatinine =1.5 mg/dL or 0 hour MTX level = 20 µmol/L
- Methotrexate (MTX) reduced by 50% for creatinine clearance 10 to 50 mL/min (eliminated for < 10 mL/min), by 25% to 75% for delayed excretion and/or nephrotoxicity with prior course (dependent on severity) or by 50% for pleural effusions/ascites with drainage of fluid as feasible.
Next cycle to start no sooner than 14 days or as soon as "unmaintained" WBC count is > 3 x 10^9/L and platelet count > 50 x 10^9/L
References
- Thomas DA, Faderl S, O'Brien S, Bueso-Ramos C, Cortes J, Garcia-Manero G, Giles FJ, Verstovsek S, Wierda WG, Pierce SA, Shan J, Brandt M, Hagemeister FB, Keating MJ, Cabanillas F, Kantarjian H. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Apr 1;106(7):1569-80. link to original article contains verified protocol PubMed
Consolidation/Intensification therapy
BASIC
back to top |
BASIC: Brief, Anthracycline-Sparing, Intensive Cyclophosphamide
Regimen
Study | Evidence |
Kasamon et al. 2012 | Non-randomized |
Treatment preceded by BASIC induction.
Chemotherapy
- Rituximab (Rituxan) 375 mg/m2 IV once on day 1
- Cyclophosphamide (Cytoxan) 50 mg/kg IV over 1 to 2 hours once per day on days 2 to 5
Supportive medications
- Mesna (Mesnex) 40 mg/kg/day IV "in divided doses" on days 2 to 5
- Filgrastim (Neupogen) 5 mcg/kg SC once per day, starting on day 11 and continuing until post-nadir ANC >1000/uL
One course, followed by:
- Rituximab (Rituxan) 375 mg/m2 IV once per week x 4 doses, once post-nadir ANC > 1000/uL
CNS treatment (only given if there was prior CNS involvement):
- Cytarabine (Cytosar) 100 mg IT once per week x 4 doses, then once every other week x 4 doses
- Hydrocortisone (Cortef) 50 mg IT is optional (no parameters given)
References
- Kasamon YL, Brodsky RA, Borowitz MJ, Ambinder RF, Crilley PA, Cho SY, Tsai HL, Smith BD, Gladstone DE, Carraway HE, Huff CA, Matsui WH, Bolaños-Meade J, Jones RJ, Swinnen LJ. Brief intensive therapy for older adults with newly diagnosed Burkitt or atypical Burkitt lymphoma/leukemia. Leuk Lymphoma. 2013 Mar;54(3):483-90. Epub 2012 Aug 17. link to original article link to PMC article contains verified protocol PubMed
CYM
back to top |
CYM: CYtarabine, Methotrexate
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II |
This regimen is for group B (unresected stage I, non-abdominal stage II and any stage III or IV disease without CNS or bone marrow involvement). Treatment preceded by COPADM.
Chemotherapy
- Cytarabine (Cytosar) 100 mg/m2/day IV continuous infusion on days 2 to 6 (total dose: 500 mg/m2)
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis
- Methotrexate (MTX) 15 mg IT once on day 2
- Cytarabine (Cytosar) 30 mg IT once on day 6
- Hydrocortisone (Cortef) 15 mg IT once per day on days 2 & 6 (admixed with chemo)
2 cycles; intervals were as short as possible, as soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L
Treatment followed by COPADM maintenance.
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
CYVE
back to top |
CYVE: CYtarabine, VEpesid (Etoposide)
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II, <20 pts in this arm |
This regimen is for group C (CNS and/or bone marrow involvement). Note the unusual schedule of cytarabine; presumably the low-dose and high-dose portions are given at separate times in the 24 hour period but this detail is not further specified in the manuscript. Treatment preceded by COPADM.
Chemotherapy
- Cytarabine (Cytosar) as follows:
- 50 mg/m2 IV over 12 hours once per day on days 1 to 5
- 3000 mg/m2 IV over 3 hours once per day on days 2 to 5
- Etoposide (Vepesid) 200 mg/m2 IV once per day on days 2 to 5
2 cycles; intervals were as short as possible, as soon as the ANC was >1.5 × 109/L and platelet count was >100 × 109/L
Treatment followed by COPAD alternating with CYVE maintenance.
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
Maintenance therapy
COPAD/CYVE
back to top |
COPAD: Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin)
CYVE: CYtarabine, VEpesid (Etoposide)
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II, <20 pts in this arm |
This regimen is for group C (CNS and/or bone marrow involvement). Treatment preceded by CYVE consolidation. Note that the days of administration for the CYVE cycles are counted from the start of the respective COPAD cycles.
COPAD
- Cyclophosphamide (Cytoxan) 500 mg/m2 IV once per day on days 1 & 2
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2/day PO on days 1 to 5
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
CNS treatment
Note: this is only given with the first cycle of maintenance; patients with positive CNS at diagnosis were to also undergo 24 Gy of cranial irradiation.
- Methotrexate (MTX) 15 mg IT once on day 2
- Cytarabine (Cytosar) 40 mg IT once on day 2
- Hydrocortisone (Cortef) 15 mg IT once on day 2 (admixed with MTX & Ara-C)
CYVE
- Cytarabine (Cytosar) 50 mg/m2 SC BID on days 28 to 32
- Etoposide (Vepesid) 150 mg/m2 IV once per day on days 28 to 30
4 alternating cycles (COPAD -> CYVE -> COPAD -> CYVE)
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed
COPADM
back to top |
COPADM: Cyclophosphamide, Oncovin (Vincristine), Prednisone, ADriamycin (Doxorubicin), Methotrexate
Regimen
Study | Evidence |
Diviné et al. 2005 (LMB95) | Phase II |
This regimen is for group B (unresected stage I, non-abdominal stage II and any stage III or IV disease without CNS or bone marrow involvement). Treatment is preceded by CYM consolidation.
Chemotherapy
- Cyclophosphamide (Cytoxan) 500 mg/m2 IV once per day on days 1 & 2
- Vincristine (Oncovin) 1.4 mg/m2 (max dose of 2 mg) IV once on day 1
- Prednisone (Sterapred) 60 mg/m2/day PO on days 1 to 5
- Doxorubicin (Adriamycin) 60 mg/m2 IV once on day 2
- Methotrexate (MTX) 3000 mg/m2 IV over 3 hours once on day 1
Supportive medications
- Folinic acid (Leucovorin) 15 mg/m2 (route not specified) q6h on days 2 to 4
CNS prophylaxis
- Methotrexate (MTX) 15 mg IT once on day 2
- Hydrocortisone (Cortef) 15 mg IT once on day 2 (admixed with MTX)
One cycle
References
- Diviné M, Casassus P, Koscielny S, Bosq J, Sebban C, Le Maignan C, Stamattoulas A, Dupriez B, Raphaël M, Pico JL, Ribrag V; GELA; GOELAMS. Burkitt lymphoma in adults: a prospective study of 72 patients treated with an adapted pediatric LMB protocol. Ann Oncol. 2005 Dec;16(12):1928-35. Epub 2005 Nov 10. link to original article contains verified protocol PubMed