The Evaluation and Treatment (Tx) of Burkitt Lymphoma (BL) in the Modern Era: Real World (RW) Outcomes and Prognostication across 26 US Cancer Centers (CC)

• Published in: Blood 2019-11, Vol.134 (Supplement_1), p.397-397
• Main Authors: Evens, Andrew M., Danilov, Alexey, Jagadeesh, Deepa, Sperling, Amy, Kim, Seo-Hyun, Vaca, Ryan, Wei, Catherine, Rector, Daniel, Sundaram, Suchitra, Reddy, Nishitha, Lin, Yong, Farooq, Umar, D'Angelo, Christopher, Bond, David A., Berg, Stephanie, Churnetski, Michael C., Godara, Amandeep, Khan, Nadia, Choi, Yun Kyong, Yazdy, Maryam, Rabinovich, Emma, Varma, Gaurav, Karmali, Reem, Mian, Agrima, Ramdial, Jeremy, Burkart, Madelyn, Martin, Peter, Ren, Albert, Chauhan, Ayushi, Diefenbach, Catherine, Straker-Edwards, Allandria, Klein, Andreas, Blum, Kristie A., Boughan, Kirsten M, Smith, Scott E., Haverkos, Brad M., Orellana-Noia, Victor M., Kenkre, Vaishalee P., Zayac, Adam, Maliske, Seth M, Epperla, Narendranath, Venugopal, Parameswaran, Feldman, Tatyana A., Smith, Stephen D., Stadnik, Andrzej, Lossos, Izidore S., David, Kevin A., Naik, Seema, Caimi, Paolo, Kamdar, Manali, Portell, Craig A., Olszewski, Adam J, Alderuccio, Juan Pablo
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2019-122971

Introduction: Historically, outcomes for BL have improved in adults using dose intensive chemotherapy regimens and early CNS prophylaxis. More recent data using a less intensive regimen, DA-EPOCH, have been reported. We analyzed detailed patient (pt) & disease characteristics and treatment patterns across 26 US CCs over a recent 9 year (yr) period and also determined survival rates & prognostication. Methods: We conducted a large multicenter retrospective study of newly diagnosed (dx) adult BL pts (6/2009 - 6/2018). Dx was established by institutional expert pathology review; all cases were verified for BL based on 2016 WHO criteria (high grade B cell lymphoma, BL like, etc were excluded). Survival rates were estimated by Kaplan-Meier with differences assessed by log rank test. Univariate (UVA) associations were derived via Cox model with variables P ≤0.05 entered stepwise into a multivariate (MVA) model. Using significant factors from the MVA, a prognostic survival model was constructed. Results: Among N=557 verified BL cases, clinical features included: median age 47 yrs (17-88 yrs; 24% ≥60 yrs); male 76%; HIV+ 22%; ECOG PS 0/1 76%; B symptoms 51%; elevated LDH 78% (3, 5, & 10x elevation: 44%, 29% & 15%, respectively); hemoglobin