Low-Dose Chemotherapy to Treat Burkitt Lymphoma

High dose chemotherapy has been the conventional approach to treating Burkitt Lymphoma (“BL”), one of the more aggressive forms of this disease.  However, long-term survival rates following this treatment approach have hovered only around 60% (and, of course, such treatment is highly toxic in itself, with onerous side effects).  A recent study sponsored by the National Institute of Health (“NIH”), however, has determined that low-intensity chemotherapy may be a better approach.  In the study, thirty patients with previously untreated BL were treated with EPOCH-R, a regimen that includes etoposide (E), prednisone (P), vincristine (Oncovin), cyclophosphamide (C), doxorubicin (Hydrodoxorubicin), and rituximab (R), administered at lower doses over a longer period of time than traditional chemotherapy for BL.  The overall survival rate at 5 and 6 years was 100% and 90%, respectively.

As a result of these findings, additional trials are underway to determine if the results seen in the NHI study can be replicated in adult and pediatric BL patients.  Let’s hope that those trials will validate this revised and successful approach to treating BL.

See Dunleavy K, Pittaluga S, Shovlin M, Steinberg SM, Cole D, Grant C, Widemann B, Staudt LM, Jaffe ES,  Little RF, and Wilson WH . Low-Intensity Therapy in Adult Burkitt Lymphoma. NEJM. Nov. 14, 2013.  DOI: 10.1056/NEJMoa1308392.  A discussion of this study may be found at http://www.cancer.gov/newscenter/newsfromnci/2013/BurkittEPOCH.