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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

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
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
Background: Burkitt’s lymphoma (BL) is a rare and rapidly progressive form of B-cell non-Hodgkin’s lymphoma. Cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate (CODOX-M)/ifosfamide, etoposide and high-dose cytarabine (IVAC) is a highly effective alternating non-cross-resistant regimen developed by Magrath et al. (Magrath I., Adde M., Shad A. et al. J Clin Oncol 1996; 14: 925–934) at the US National Cancer Institute. The aim was to confirm these results in a larger, international, multi-centre study using International Prognostic Index-based criteria to assign prognostic groups, whilst slightly simplifying the protocol.
Patients and methods: a phase II study where: (i) low risk (LR) patients were treated with three cycles of modified CODOX-M; and (ii) high risk (HR) patients received treatment with four cycles of alternating modified CODOX-M and IVAC chemotherapy. Target of 60 patients, fit for protocol treatment, from 16 to 60 years of age with locally diagnosed, non-HIV-related, non-organ-transplant-related BL.
Results: results are given for 52 of 72 registered patients whose pathological eligibility was confirmed by central pathology review: 12 LR plus 40 HR. The majority of patients (n = 41) completed protocol treatment, but toxicity was severe, especially myelosuppression and mucositis. Overall, 2-year event-free survival (EFS) was 64.6% (95% CI 50.4% to 78.9%) and 2-year overall survival (OS) was 72.8% (95% CI 59.4% to 86.3%). For LR, 2-year EFS was 83.3% and OS was 81.5%. For HR, 2-year EFS was 59.5% and OS was 69.9%.
Conclusions: this study confirms high cure rates with this CODOX-M/IVAC approach.
burkitt’s lymphoma, chemotherapy, codox-m, ivac
0923-7534
1264-1274
Mead, G.M.
8a97f978-9c66-4a16-bb03-dd83d20b06a0
Sydes, M.R.
bec44176-a377-4bfb-87c1-f5397426fcf4
Walewski, J.
484ad2fa-a169-4a32-892c-894d50eda025
Grigg, A.
9c39e0c5-b817-400b-9394-0d04eede564f
Hatton, C.S.
6fb3016d-711e-4e35-981a-bee125506dbb
Pescosta, N.
bbebe83f-fc79-46d3-84c6-11be39ed9dfd
Guarnaccia, C.
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Lewis, M.S.
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McKendrick, J.
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Stenning, S.P.
322b2b99-e6c5-46e5-a581-acb46357a418
Wright, D.
cb71b236-ab48-4942-a7bd-5617f607f9d0
Mead, G.M.
8a97f978-9c66-4a16-bb03-dd83d20b06a0
Sydes, M.R.
bec44176-a377-4bfb-87c1-f5397426fcf4
Walewski, J.
484ad2fa-a169-4a32-892c-894d50eda025
Grigg, A.
9c39e0c5-b817-400b-9394-0d04eede564f
Hatton, C.S.
6fb3016d-711e-4e35-981a-bee125506dbb
Pescosta, N.
bbebe83f-fc79-46d3-84c6-11be39ed9dfd
Guarnaccia, C.
48556588-3218-4386-81d7-75ae049c3eb7
Lewis, M.S.
989d86cf-3fbd-4fd4-a1a0-5591ffecb071
McKendrick, J.
c485d931-6c98-4839-ada7-250ebd9175e6
Stenning, S.P.
322b2b99-e6c5-46e5-a581-acb46357a418
Wright, D.
cb71b236-ab48-4942-a7bd-5617f607f9d0

Mead, G.M., Sydes, M.R., Walewski, J., Grigg, A., Hatton, C.S., Pescosta, N., Guarnaccia, C., Lewis, M.S., McKendrick, J., Stenning, S.P. and Wright, D. (2002) 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. Annals of Oncology, 13 (8), 1264-1274. (doi:10.1093/annonc/mdf253).

Record type: Article

Abstract

Background: Burkitt’s lymphoma (BL) is a rare and rapidly progressive form of B-cell non-Hodgkin’s lymphoma. Cyclophosphamide, vincristine, doxorubicin, high-dose methotrexate (CODOX-M)/ifosfamide, etoposide and high-dose cytarabine (IVAC) is a highly effective alternating non-cross-resistant regimen developed by Magrath et al. (Magrath I., Adde M., Shad A. et al. J Clin Oncol 1996; 14: 925–934) at the US National Cancer Institute. The aim was to confirm these results in a larger, international, multi-centre study using International Prognostic Index-based criteria to assign prognostic groups, whilst slightly simplifying the protocol.
Patients and methods: a phase II study where: (i) low risk (LR) patients were treated with three cycles of modified CODOX-M; and (ii) high risk (HR) patients received treatment with four cycles of alternating modified CODOX-M and IVAC chemotherapy. Target of 60 patients, fit for protocol treatment, from 16 to 60 years of age with locally diagnosed, non-HIV-related, non-organ-transplant-related BL.
Results: results are given for 52 of 72 registered patients whose pathological eligibility was confirmed by central pathology review: 12 LR plus 40 HR. The majority of patients (n = 41) completed protocol treatment, but toxicity was severe, especially myelosuppression and mucositis. Overall, 2-year event-free survival (EFS) was 64.6% (95% CI 50.4% to 78.9%) and 2-year overall survival (OS) was 72.8% (95% CI 59.4% to 86.3%). For LR, 2-year EFS was 83.3% and OS was 81.5%. For HR, 2-year EFS was 59.5% and OS was 69.9%.
Conclusions: this study confirms high cure rates with this CODOX-M/IVAC approach.

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Published date: August 2002
Keywords: burkitt’s lymphoma, chemotherapy, codox-m, ivac
Organisations: Cancer Sciences

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Local EPrints ID: 26473
URI: http://eprints.soton.ac.uk/id/eprint/26473
ISSN: 0923-7534
PURE UUID: 3c24136b-2a25-4c1f-8837-c3d4a88ecda1

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Date deposited: 21 Apr 2006
Last modified: 15 Jul 2019 19:14

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Contributors

Author: G.M. Mead
Author: M.R. Sydes
Author: J. Walewski
Author: A. Grigg
Author: C.S. Hatton
Author: N. Pescosta
Author: C. Guarnaccia
Author: M.S. Lewis
Author: J. McKendrick
Author: S.P. Stenning
Author: D. Wright

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