Minimal Disseminated Disease in High-Risk Burkitt's Lymphoma Identifies Patients With Different Prognosis

Mussolin, Lara; Pillon, Marta; dʼAmore, Emanuele S.G.; Conter, Valentino; Piglione, Matilde; Nigro, Luca Lo; Garaventa, Alberto; Buffardi, Salvatore; Aricò, Maurizio; Rosolen, Angelo

doi:10.1200/jco.2010.32.8161

Cited by 45 publications

(43 citation statements)

References 18 publications

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“…Another approach utilized long-distance PCR to detect t(8;14)(224;q32), the most common translocation in BL, within bone marrow samples from newly diagnosed paediatric BL patients (Mussolin et al, 2011). The translocation was detected in 26/84 patients (31%), which was higher than the rate of morphological detection (18%).…”

Section: Minimal Disease Detectionmentioning

confidence: 79%

Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia

2012

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SummaryBurkitt lymphoma/leukaemia is the most common (40%) form of non-Hodgkin lymphoma that occurs in children and adolescents. The prognosis of advanced (disseminated) Burkitt lymphoma/leukaemia in children and adolescents three decades ago had a 5-year event-free survival (EFS) of <40%, and required combination chemotherapy and radiation therapy over a 1-2 year period. Currently, the prognosis for the same advanced stage has a 5-year EFS of 85-90% with <6 months of chemotherapy only. Radiation therapy has been eliminated for children and adolescents with Burkitt lymphoma/leukaemia except in emergencies, such as superior vena cava syndrome and acute neurological impairment or in patients with relapse/progression. Current risk factors in the prognosis of childhood and adolescent Burkitt lymphoma/leukaemia include: lactate dehydrogenase level 29 the upper normal limit at diagnosis, bone marrow and central nervous system involvement, poor response to cyclophosphamide, vincristine and prednisone reduction therapy and poor risk cytogenetics. New and novel therapeutic approaches include monoclonal antibody (anti-CD20) therapy, targeted cellular immune therapy and small molecule inhibitors. Future strategies should include improved staging and risk classification, reduction of cytotoxic chemotherapy, the investigation of targeted therapy, an increased understanding of the underlying biology of Burkitt lymphoma/leukaemia, strategies for prevention and approaches to reduce acute and chronic toxicities.

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Section: Minimal Disease Detectionmentioning

confidence: 79%

Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia

2012

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“…Bone marrow (BM) and central nervous system (CNS) are involved in about 20-25% of the cases. Lymphoblasts are characterized by surface expression of B-cell markers, particularly CD19, CD20 and immunoglobulin (Ig) M (Mussolin et al, 2011). The t(8;14)(q24;q32) chromosomal translocation is observed in about 75% of BL/B-AL cases, and can thus be used as a marker to study minimal BM infiltration (Mussolin et al, 2003(Mussolin et al, , 2007Lovisa et al, 2009).…”

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confidence: 99%

Detection of prognostic factors in children and adolescents with Burkitt and Diffuse Large B‐Cell Lymphoma treated with theAIEOP LNH‐97 protocol

et al. 2016

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SummaryBurkitt lymphoma (BL) and Diffuse Large B-Cell Lymphoma (DLBCL) account for most cases of non-Hodgkin lymphoma (NHL) in childhood. We report the clinical characteristics, outcome and prognostic factors in children with BL or DLBCL treated according to the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP) LNH-97 protocol. Patients aged up to 18 years that were newly diagnosed with BL/DLBCL were included in the study. Therapy consisted of pre-phase followed by 2-6 high-dose chemotherapy courses tailored according to lactate dehydrogenase (LDH) value and disease stage. A total of 442 patients (379 BL, 63 DLBCL) were enrolled between 1997 and 2014, of whom 18 failed to achieve remission, 6 experienced treatment-related death, 2 developed second malignancy and 20 relapsed. At a median follow-up time of 5 years, overall survival was 93% (AE1%) and event-free survival was 90% (AE1%). LDH value above the median value had an independently negative prognostic value (P < 0Á0001). However, in the subgroup of 128 patients in which minimal disseminated disease (MDD) was analysed, MDD-positivity became the only unfavourable prognostic factor for progression-free survival. Tailored chemotherapy could be extremely effective with limited toxicity. Identification of MDD as a hallmark of a higher risk of treatment failure may provide a target population for treatment intensification by anti-CD20.

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“…Minimal residual disease (MRD) monitoring during follow-up may help identify those who may have a higher risk of relapse and early treatment intensification; further studies and validation are required to define the place of MRD monitoring in treatment planning. [74][75][76] The role of monoclonal antibodies including rituximab and newer agents in conditioning regimes is expanding, and reports of outcomes for patients treated with these regimes are awaited in the hope that they will further improve on treatment strategies and outcomes in these patients. …”

Section: Discussionmentioning

confidence: 99%

The role of hematopoietic SCT in adult Burkitt lymphoma

Ahmed

Sureda

Aljurf

2012

Bone Marrow Transplant

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Minimal Disseminated Disease in High-Risk Burkitt's Lymphoma Identifies Patients With Different Prognosis

Abstract: MDD identifies a poor-prognosis subgroup among children with high-risk BL. To improve disease control in these patients, a more effective risk-adapted therapy, possibly including anti-CD20 monoclonal antibody, should be considered.

Cited by 45 publications

References 18 publications

Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia

Risk factors and treatment of childhood and adolescent Burkitt lymphoma/leukaemia

Detection of prognostic factors in children and adolescents with Burkitt and Diffuse Large B‐Cell Lymphoma treated with theAIEOP LNH‐97 protocol

The role of hematopoietic SCT in adult Burkitt lymphoma

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