Efficacy of the GMALL‐B‐ALL/NHL2002 protocol in Burkitt leukemia/lymphoma and aggressive non‐Hodgkin‐lymphomas with or without CNS involvement

2019 
OBJECTIVES: The GMALL-B-ALL/NHL2002 protocol is effective in Burkitt lymphoma/leukemia (BL). Its role in other aggressive lymphomas and in patients with simultaneous central nervous system (CNS) and peripheral involvement is unclear. METHODS: This is a retrospective outcome analysis in 76 patients with BL (n = 26), B-lymphoblastic lymphoma (B-LBL; n = 3), diffuse large B-cell lymphoma (DLBCL; n = 31), mantle cell lymphoma (MCL; n = 6), transformed B-cell non-Hodgkin lymphomas (tB-NHL; n = 7), and T-cell NHL (T-NHL; n = 3) treated with the GMALL-B-ALL/NHL2002 protocol. RESULTS: 73.1% of scheduled chemotherapy cycles were administered. Treatment was discontinued in 38 patients (50.0%) due to progression (n = 14), toxicities (n = 11), scheduled treatment change (n = 6), and unknown reasons (n = 7). All BL/B-LBL patients were treated first-line, and at a median follow-up of 124.7 months, median progression-free survival was not reached. In DLBCL, median PFS was 68.4 months in first-line treated patients and 3.7 months in relapsed/refractory patients. CNS involvement was present in 10 non-BL/B-LBL cases and did not have a negative impact on survival in first-line treated patients but was fatal in all relapsed/refractory patients. CONCLUSION: This study confirmed the activity of the GMALL-B-ALL/NHL2002 protocol in BL/B-LBL. It was also effective in first-line treated non-BL/B-LBL lymphomas with and without simultaneous CNS-/peripheral involvement, but ineffective in relapsed/refractory disease.
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