Comparison of CHOP treatment with specific short-intensive chemotherapy in AIDS-related Burkitt's lymphoma or leukemia

Background and objective: AIDS-related Burkitt's lymphoma or leukemia (BLL) is increasingly treated with specific and intensive multiagent schedules. This retrospective study aimed to compare the results of CHOP with those from two protocols (PETHEMA-LAL3/97 and BURKIMAB) of specific therapy in Spain.

Patients and methods: Patients from Group A (n=31) received 6 standard CHOP cycles every 3 weeks. Patients from group B (n=44) received six multiagent cycles including high-dose methotrexate and high-dose cytarabine. The response to therapy, disease-free survival and overall survival (OS) were compared in the two groups.

Results: Both groups were comparable for the main clinical and biological parameters at diagnosis except for risk activity, previous HAART, bone marrow involvement, bulky disease and extranodal involved sites. Complete remission (CR) was achieved in 10 out of 31 (32%) patients in group A and 28 out of 44 (67%) patients in group B (P=.005). After a median (range) follow-up of 70 (26-139) and 17 (1-134) months, the 5-year (95% CI) DFS probability was 87% (64%-100%) for group A and 70% (51%-89%) for group B (P=.374), and the 5-year (95% CI) OS was 27% (10%-43%) for Group A and 57% (40%-74%) for group B (P=.028). Multivariate analyses showed that specific therapy was associated with an improved CR and OS.

Conclusions: In AIDS-related BLL short intensive specific chemotherapy is feasible, with higher remission rate and improved survival than that obtained with CHOP-based regimens.